Rituximab/bendamustine and rituximab/cytarabine induction therapy for transplant-eligible mantle cell lymphoma

Reid W. Merryman, Natasha Edwin, Robert Redd, Jad Bsat, Matthew Chase, Ann LaCasce, Arnold Freedman, Caron Jacobson, David Fisher, Samuel Ng, Jennifer Crombie, Austin Kim, Oreofe Odejide, Matthew S. Davids, Jennifer R. Brown, Heather Jacene, Amanda Cashen, Nancy L. Bartlett, Neha Mehta-Shah, Armin GhobadiBrad Kahl, Robin Joyce, Philippe Armand, Eric Jacobsen

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

The addition of high-dose cytarabine to rituximab/bendamustine (RB) induction could improve outcomes for transplant-eligible patients with mantle cell lymphoma (MCL). We conducted a pooled analysis of 2 phase 2 trials and an off-trial cohort each testing 3 cycles of RB and 3 cycles of rituximab/high-dose cytarabine (RC) followed by autologous stem cell transplantation (ASCT) among untreated, transplant-eligible patients with MCL. Dana- Farber Cancer Institute (DFCI) and Washington University in St. Louis (WUSTL) led separate phase 2 trials testing sequential and alternating cycles of RB/RC, respectively. Patients treated at DFCI with sequential RB/RC off trial were retrospectively identified. Minimal residual disease (MRD) was assessed in the DFCI trial. A total of 88 patients (23 DFCI trial, 18 WUSTL trial, and 47 off trial) received RB/RC; 92% of patients completed induction, and 84% underwent planned consolidative ASCT. Grade 3 or 4 adverse events among trial patients included lymphopenia (88%), thrombocytopenia (85%), neutropenia (83%), and febrile neutropenia (15%). There were no treatment-related deaths during induction and 2 following ASCT. Among 87 response-evaluable patients, the end-of-induction overall and complete response rates were 97% and 90%, respectively. After a median follow-up of 33 months, 3-year progression-free survival and overall survival were 83% and 92%, respectively. Patients undergoing MRD testing experienced prolonged MRD negativity after ASCT with emergence of MRD occurring in only 1 patient who subsequently relapsed. RB/RC followed by ASCT achieves high rates of durable remissions in transplant-eligible patients with MCL.

Original languageEnglish
Pages (from-to)858-867
Number of pages10
JournalBlood Advances
Volume4
Issue number5
DOIs
StatePublished - Mar 10 2020

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  • Cite this

    Merryman, R. W., Edwin, N., Redd, R., Bsat, J., Chase, M., LaCasce, A., Freedman, A., Jacobson, C., Fisher, D., Ng, S., Crombie, J., Kim, A., Odejide, O., Davids, M. S., Brown, J. R., Jacene, H., Cashen, A., Bartlett, N. L., Mehta-Shah, N., ... Jacobsen, E. (2020). Rituximab/bendamustine and rituximab/cytarabine induction therapy for transplant-eligible mantle cell lymphoma. Blood Advances, 4(5), 858-867. https://doi.org/10.1182/bloodadvances.2019001355