High-dose cyclophosphamide and rituximab without stem cell transplant: A feasibility study for low grade B-cell, transformed and mantle cell lymphomas

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Abstract

Relapse after autologous stem cell transplant for low grade B-cell lymphoma is common secondary to ineffective conditioning and/or tumor autograft contamination. We investigated high-dose cyclophosphamide and rituximab without stem cell rescue as first-line or salvage therapy in lymphomas. After establishing safety, accrual was increased to evaluate event-free survival (EFS). Eighty-one adults received rituximab (375 mg/m 2 days 1, 4, 8, 11, 45, 52), cyclophosphamide (50 mg/kg days 1518), and pegfilgrastim (day 20). Forty-two patients had low grade B-cell lymphoma [grade I/II follicular (69%), transformed lymphoma (17%), other (15%)]: 45% were treated without measurable disease. Thirty-nine patients had mantle cell lymphoma: 82% were treated without measurable disease. All achieved hematopoietic recovery; 46% required brief hospitalizations. The 5-year EFS and overall survival (OS) for patients with low grade B-cell and transformed lymphoma were 40% and 72%, respectively. The 5-year EFS and OS for patients with MCL were 39% and 62%, respectively. This low-toxicity therapeutic approach obviates the need for stem cell products and establishes a platform for future therapies.

Original languageEnglish (US)
Pages (from-to)2076-2081
Number of pages6
JournalLeukemia and Lymphoma
Volume52
Issue number11
DOIs
StatePublished - Nov 1 2011

Keywords

  • Cyclophosphamide
  • Mantle cell lymphoma
  • NHL

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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