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Treatment of mantle-cell lymphoma with Rituximab (chimeric monoclonal anti-CD20 antibody): analysis of factors associated with response

Treatment of mantle-cell lymphoma with Rituximab (chimeric monoclonal anti-CD20 antibody): analysis of factors associated with response
Treatment of mantle-cell lymphoma with Rituximab (chimeric monoclonal anti-CD20 antibody): analysis of factors associated with response
BACKGROUND: A retrospective analysis was performed to delineate the factors associated with response, and to determine the duration of response, in 87 patients with CD20-positive mantle-cell lymphoma (MCL) treated with Rituximab (chimeric monoclonal anti-CD20 antibody) in two prior studies. PATIENTS AND METHODS: Patients with newly-diagnosed MCL (MCL1, n = 37), and previously-treated MCL (MCL2, n = 50), received single-agent Rituximab, in the context of two multicentre clinical studies using different schedules and doses, conducted in 1996 and 1997. A follow-up analysis was performed at the end of 1998, including all 81 patients who completed therapy. Statistical modeling of factors associated with response was performed using ordered logistic regression. The duration of complete (CR) and partial response (PR), and the time to disease progression (TTP), were also derived. RESULTS: The overall response rate (RR) was 34% (30 of 87) (81 evaluable patients, RR 37%; CR 14%), and was equivalent for MCL1 and MCL2. On univariate analysis, elevated LDH (P = 0.004); prior therapy with alkylating agents (P = 0.01) or fludarabine phosphate (P = 0.04); WHO performance status = 2 (P = 0.02); MCL2 refractory to last prior therapy (P = 0.04); and splenomegaly (P = 0.04), each at the time of treatment with Rituximab, were significantly associated with a lower RR. On multivariate analysis, only LDH (P = 0.007) and prior alkylating agents (P = 0.03) retained statistical significance. At a median follow-up of 1.4 years, the median TTP was 7 months. The median duration of response was one year, and was significantly longer for patients achieving CR vs. PR (P = 0.04). CONCLUSIONS: Rituximab is active in MCL, and can induce complete responses in a minority of patients. Elevated LDH at the time of therapy, and prior therapy with alkylating agents, are associated with a significantly lower RR. The duration of response of one year is similar to that previously reported in follicular lymphoma.
1569-8041
S117-S121
Foran, J.M.
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Cunningham, D.
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Coiffier, B.
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Solal-Celigny, P.
d8092bde-1381-40e9-855f-11cf90bb2344
Reyes, F.
4f9b99ab-6e1f-4f98-85bc-2889a1255d84
Ghielmini, M.
15f98221-e7cd-4d0f-975d-ba05c6673547
Johnson, Peter W.M.
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Gisselbrecht, C.
0889fc96-7d28-49dc-8c75-25361e8e2c8c
Bradburn, M.
1de9ef82-6406-4dcb-aa5a-037c5fca3898
Matthews, J.
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Lister, T. A.
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Foran, J.M.
4b469095-77d2-4c02-92ec-3d3751d4cbf0
Cunningham, D.
02b4fd3a-f452-4419-96a7-f98f609f098d
Coiffier, B.
2760ae53-a2aa-45a3-93be-3375cf82eb9b
Solal-Celigny, P.
d8092bde-1381-40e9-855f-11cf90bb2344
Reyes, F.
4f9b99ab-6e1f-4f98-85bc-2889a1255d84
Ghielmini, M.
15f98221-e7cd-4d0f-975d-ba05c6673547
Johnson, Peter W.M.
3f6068ce-171e-4c2c-aca9-dc9b6a37413f
Gisselbrecht, C.
0889fc96-7d28-49dc-8c75-25361e8e2c8c
Bradburn, M.
1de9ef82-6406-4dcb-aa5a-037c5fca3898
Matthews, J.
4c708491-7509-44d6-9375-2b7313a36f3e
Lister, T. A.
0de6a9a4-2fe0-41b0-8226-a10d28d31f4c

Foran, J.M., Cunningham, D., Coiffier, B., Solal-Celigny, P., Reyes, F., Ghielmini, M., Johnson, Peter W.M., Gisselbrecht, C., Bradburn, M., Matthews, J. and Lister, T. A. (2000) Treatment of mantle-cell lymphoma with Rituximab (chimeric monoclonal anti-CD20 antibody): analysis of factors associated with response. Annals of Oncology, 11 (Supplement 1), S117-S121. (doi:10.1093/annonc/11.suppl_1.S117).

Record type: Article

Abstract

BACKGROUND: A retrospective analysis was performed to delineate the factors associated with response, and to determine the duration of response, in 87 patients with CD20-positive mantle-cell lymphoma (MCL) treated with Rituximab (chimeric monoclonal anti-CD20 antibody) in two prior studies. PATIENTS AND METHODS: Patients with newly-diagnosed MCL (MCL1, n = 37), and previously-treated MCL (MCL2, n = 50), received single-agent Rituximab, in the context of two multicentre clinical studies using different schedules and doses, conducted in 1996 and 1997. A follow-up analysis was performed at the end of 1998, including all 81 patients who completed therapy. Statistical modeling of factors associated with response was performed using ordered logistic regression. The duration of complete (CR) and partial response (PR), and the time to disease progression (TTP), were also derived. RESULTS: The overall response rate (RR) was 34% (30 of 87) (81 evaluable patients, RR 37%; CR 14%), and was equivalent for MCL1 and MCL2. On univariate analysis, elevated LDH (P = 0.004); prior therapy with alkylating agents (P = 0.01) or fludarabine phosphate (P = 0.04); WHO performance status = 2 (P = 0.02); MCL2 refractory to last prior therapy (P = 0.04); and splenomegaly (P = 0.04), each at the time of treatment with Rituximab, were significantly associated with a lower RR. On multivariate analysis, only LDH (P = 0.007) and prior alkylating agents (P = 0.03) retained statistical significance. At a median follow-up of 1.4 years, the median TTP was 7 months. The median duration of response was one year, and was significantly longer for patients achieving CR vs. PR (P = 0.04). CONCLUSIONS: Rituximab is active in MCL, and can induce complete responses in a minority of patients. Elevated LDH at the time of therapy, and prior therapy with alkylating agents, are associated with a significantly lower RR. The duration of response of one year is similar to that previously reported in follicular lymphoma.

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Published date: 2000

Identifiers

Local EPrints ID: 157837
URI: http://eprints.soton.ac.uk/id/eprint/157837
ISSN: 1569-8041
PURE UUID: b7273680-2ecc-402c-a166-e8b723b8eb37
ORCID for Peter W.M. Johnson: ORCID iD orcid.org/0000-0003-2306-4974

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Date deposited: 16 Jun 2010 13:39
Last modified: 17 Dec 2019 01:55

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Contributors

Author: J.M. Foran
Author: D. Cunningham
Author: B. Coiffier
Author: P. Solal-Celigny
Author: F. Reyes
Author: M. Ghielmini
Author: C. Gisselbrecht
Author: M. Bradburn
Author: J. Matthews
Author: T. A. Lister

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