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Rituximab plus HyperCVAD alternating with high dose cytarabine and methotrexate for the initial treatment of patients with mantle cell lymphoma, a multicentre trial from Gruppo Italiano Studio Linfomi
Author(s) -
Merli Francesco,
Luminari Stefano,
Ilariucci Fiorella,
Petrini Mario,
Visco Carlo,
Ambrosetti Achille,
Stelitano Caterina,
Caracciolo Francesco,
Di Renzo Nicola,
Angrilli Francesco,
Carella Angelo M.,
Capodanno Isabella,
Barbolini Elisa,
Galimberti Sara,
Federico Massimo
Publication year - 2012
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2011.08958.x
Subject(s) - medicine , mantle cell lymphoma , rituximab , cytarabine , regimen , gastroenterology , international prognostic index , autologous stem cell transplantation , methotrexate , surgery , confidence interval , chemotherapy , lymphoma
Summary This study investigated the clinical activity and toxicity of R‐HCVAD‐AM [rituximab plus HyperCVAD (R‐HCVAD) alternating with high‐dose cytarabine and methotrexate (AM)] in patients with newly diagnosed Mantle Cell Lymphoma (MCL). Patients aged ≤70 years with confirmed MCL received four alternating cycles each of R‐HCVAD and AM. Patients who obtained a partial response proceeded to autologous stem cell transplant. Sixty‐three patients were enrolled and 60 were fully eligible. Median age was 57 years (22–66); 60%, 33% and 7% were classified at low (L)‐, intermediate (I)‐ or high (H)‐risk, respectively, according to the MCL International Prognostic Index (MIPI). Only 22 patients (37%) completed the four cycles and three patients died during therapy. Overall response and complete response rates were 83% and 72% respectively. After a median follow‐up of 46 months (range 1–72) the estimated 5‐year overall survival (OS) and progression‐free survival rates were 73% [95% confidence interval (CI) 59–83%], and 61% (95%CI 45–73%) respectively. MIPI maintained the prognostic value with an estimated 5‐year OS of 89%, 80% and 24% for L, I, and H groups respectively ( P < 0·001). This multicentre study confirms that R‐HCVAD‐AM is an active regimen for the initial treatment of patients with MCL, but is associated with significant toxicity.