Evaluating rituximab maintenance therapy for mantle cell lymphoma

This study investigated the effectiveness of rituximab (Rituxan) maintenance therapy (treatment that is meant to help a primary treatment succeed) in patients with mantle cell lymphoma. The study concluded that this therapy improved survival outcomes in these patients after stem cell transplantation.

Chemoimmunotherapy is the typical first-line (primary) treatment for patients with mantle cell lymphoma. While 80 – 90% of patients respond to treatment, relapses (return of the cancer) are common. Stem cell transplantation (SCT) is one possible treatment option, but some patients are not good candidates.

Maintenance therapy with rituximab is an option for patients who responded to initial treatment, even for those who cannot have a stem cell transplant. The goal of this therapy is to help patients maintain remission. The impact of this therapy on survival outcomes for patients with mantle cell lymphoma remains under investigation.

This study analyzed the results of 7 studies comparing rituximab maintenance therapy to interferon therapy or observation (control group). Overall, 1060 patients were analyzed. Patients had newly diagnosed disease (60 – 70%) or relapsed disease (30 – 40%). 62.3% of patients previously had a SCT. The average follow-up period was 49 months.

SCT-treated patients who had rituximab maintenance therapy had a 65% lower risk of death and a 67% lower risk of disease progression compared to patients in the control group. 

For SCT-ineligible patients, there was a 62% lower risk of disease progression in the rituximab maintenance therapy group compared to the control group. Overall survival (patients still alive) could not be estimated due to lack of data. 

This study concluded that rituximab maintenance therapy improved survival outcomes in patients with mantle cell lymphoma after stem cell transplantation. Outcomes for SCT-ineligible patients remain unclear.

Only three out of the seven studies analyzed were clinical trials. For the rest, the researchers only observed patients’ outcomes, without trying to change the treatment.