Rituximab maintenance improves follicular lymphoma survival

NEW YORK (Reuters Health) - Recent findings published in the February 18th issue of the Journal of the National Cancer Institute suggest that in patients with relapsed or refractory follicular lymphoma, rituximab maintenance therapy after chemotherapy improves overall survival.

"Follicular lymphoma is characterized by slow growth and an initially high rate of response to treatment, but patients typically relapse and experience progressive disease," Dr. Liat Vidal, of Rabin Medical Center, Petah-Tikva, Israel, and colleagues write.

The researchers performed a systematic review and meta-analysis of randomized controlled trials that compared rituximab maintenance therapy at relapse with observation or other treatment. Five studies including 1143 patients were included.

Data on 985 patients were available for the meta-analysis of overall survival, which was significantly better among patients treated with rituximab maintenance therapy than in control patients (HR for death = 0.60). The type of rituximab maintenance schedule did not affect overall survival, according to the authors.

In addition, compared to observation, rituximab provided a clear survival benefit to patients with refractory or relapsed follicular lymphoma (HR for death = 0.58).

The pooled HRs of event-free and progression-free intervals were 0.46 and 0.53, respectively. Patients who received rituximab maintenance therapy had a higher rate of infection-related adverse events than those in the observation group (RR = 1.99).

"Our results suggest that rituximab maintenance therapy for up to 2 years, either as four weekly infusions every 6 months or as a single infusion every 2 to 3 months, should be added to standard therapy of patients with relapsed or refractory follicular lymphoma after successful induction treatment," Dr. Vidal's team concludes.

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