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Background  In B cell non-Hodgkin lymphoma (B-NHL), rituximab-containing reduced-intensity conditioning regimens (R-RIC) have been shown to provide favorable outcomes in single-arm studies; however, large multicenter studies comparing R-RIC and non-rituximab-containing reduced-intensity conditioning regimens (nonR-RIC) have not been performed. Using the CIBMTR database, we report the outcomes of R-RIC versus nonR-RIC regimens in B-NHL.    Methods  We evaluated 1401 adult B-NHL patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) who received nonR-RIC ( n  = 1022) or R-RIC ( n  = 379) regimens. Graft-versus-host disease (GVHD) prophylaxis was limited to calcineurin inhibitor-based approaches.    Results  Median follow-up of survivors in the R-RIC and nonR-RIC groups was 47 and 37 months, respectively. On multivariate analysis, no difference was seen between the R-RIC and nonR-RIC cohorts in terms of acute GVHD grade II–IV (RR = 1.14, 95%CI = 0.83–1.56,  p  = 0.43) or grade III–IV (RR = 1.16, 95%CI = 0.72–1.89,  p  = 0.54), chronic GVHD (RR = 1.15, 95%CI = 0.92–1.46,  p  = 0.22), non-relapse mortality (RR = 0.90; 95%CI = 0.67–1.22;  p  = 0.51), relapse/progression (RR = 0.79; 95%CI = 0.63–1.01;  p  = 0.055), and mortality (RR = 0.84, 95%CI = 0.69–1.02,  p  = 0.08) risk. However, R-RIC was associated with a significantly improved progression-free survival (RR = 0.76; 95%CI 0.62–0.92;  p  = 0.006). On subgroup analysis, mortality benefit was noted in the R-RIC group patients not receiving busulfan-based RIC (RR = 0.76; 95%CI = 0.60–0.96;  p  = 0.02) and with the use of a higher cumulative rituximab dose (RR = 0.43; 95%CI = 0.21–0.90;  p  = 0.02).    Conclusion  Our analysis shows that inclusion of rituximab in RIC regimens improves progression-free survival in patients with B cell NHL. These data supports the use of R-RIC in B-NHL patients undergoing allo-HCT.    Electronic supplementary material  The online version of this article (doi:10.1186/s13045-017-0487-y) contains supplementary material, which is available to authorized users.

journal of hematology and oncology

Rituximab-containing reduced-intensity conditioning improves progression-free survival following allogeneic transplantation in B cell non-Hodgkin lymphoma