Dr. Hilal Discusses Rituximab Maintenance in Mantle Cell Lymphoma

Talal Hilal, MB, BCh
Published: Friday, Jun 08, 2018



Talal Hilal, MB, BCh, assistant professor of medicine, Mayo Clinic, discusses the meta-analysis of rituximab (Rituxan) maintenance for patients with mantle cell lymphoma.

In the overall population, there was a benefit in terms of progression-free survival (PFS) and overall survival (OS) in all of the studies. In the prospective studies, the benefit was mainly PFS—there was no OS benefit. Only 3 prospective trials were included in the analysis, and only 1 used transplant. That, says Hilal, is the main driver of OS benefit in these studies.

The retrospective studies have their own limitations, states Hilal. There was a lot of heterogeneity and differences in how patients were treated. In the transplant only group, there were a couple patients who were excluded because they did not undergo transplant. In those studies, there was a PFS benefit as well, but no OS benefit.

Therefore, patients who are young, fit, and eligible for transplant should be started with an induction chemoimmunotherapy that includes cytarabine-based regimens and rituximab maintenance. It is still a question as to whether this regimen is appropriate for older patients and patients who are not eligible for transplant, says Hilal.


Talal Hilal, MB, BCh, assistant professor of medicine, Mayo Clinic, discusses the meta-analysis of rituximab (Rituxan) maintenance for patients with mantle cell lymphoma.

In the overall population, there was a benefit in terms of progression-free survival (PFS) and overall survival (OS) in all of the studies. In the prospective studies, the benefit was mainly PFS—there was no OS benefit. Only 3 prospective trials were included in the analysis, and only 1 used transplant. That, says Hilal, is the main driver of OS benefit in these studies.

The retrospective studies have their own limitations, states Hilal. There was a lot of heterogeneity and differences in how patients were treated. In the transplant only group, there were a couple patients who were excluded because they did not undergo transplant. In those studies, there was a PFS benefit as well, but no OS benefit.

Therefore, patients who are young, fit, and eligible for transplant should be started with an induction chemoimmunotherapy that includes cytarabine-based regimens and rituximab maintenance. It is still a question as to whether this regimen is appropriate for older patients and patients who are not eligible for transplant, says Hilal.



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