Long-term overall- and progression-free survival after pentostatin, cyclophosphamide and rituximab therapy for indolent non-Hodgkin lymphoma.

Abstract

In a prospective phase II trial, pentostatin combined with cyclophosphamide and rituximab (PCR) induced strong responses and was well-tolerated in previously untreated patients with advanced-stage, indolent non-Hodgkin lymphoma (iNHL). After a median patient follow-up of more than 108 months, we performed an intent-to-treat analysis of our 83 participants. Progression-free survival (PFS) rates at 108 months for follicular lymphoma (FL), marginal zone lymphoma (MZL) and small lymphocytic lymphoma (SLL) were 71%, 67% and 15%, respectively, and were affected by clinicopathological characteristics. Ten-year PFS rates for those with beta-2-microglobulin levels <2·2 and ≥2·2 mg/l prior to treatment were 71% and 21%, respectively. Patients without bone marrow involvement had 10-year PFS rates of 72% vs. 29% for those with involvement. At time of analysis, the median overall survival (OS) had not been reached. The OS rate was 64% at 10 years and differed significantly based on histology: 94% for FL, 66% for MZL and 39% for SLL. Long-term toxicities included 18 (21·7%) patients with second malignancies and 2 (2·4%) who developed myelodysplastic syndrome after receiving additional lines of chemotherapy. Our 10-year follow-up analysis confirms that PCR is an effective, robust and tolerable treatment regimen for patients with iNHL.

• Authors: Tamer Khashab, Fredrick Hagemeister, Jorge E Romaguera, Michelle A Fanale, Barbara Pro, Peter McLaughlin, M Alma Rodriguez, Sattva S Neelapu, Luis Fayad, Anas Younes, Lei Feng, Francisco Vega, Larry W Kwak, Felipe Samaniego
• Journal: British journal of haematology (Br J Haematol) Vol. 185 Issue 4 Pg. 670-678 (05 2019) ISSN: 1365-2141 [Electronic] England
• PMID: 30820940 (Publication Type: Clinical Trial, Phase II, Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2019 British Society for Haematology and John Wiley & Sons Ltd.

Chemical References

• Pentostatin
• Rituximab
• Cyclophosphamide

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bone Marrow Diseases (mortality)
• Cyclophosphamide (administration & dosage)
• Disease Progression
• Disease-Free Survival
• Female
• Humans
• Leukemia, Lymphocytic, Chronic, B-Cell (drug therapy, mortality)
• Male
• Middle Aged
• Neoplasms, Second Primary (mortality)
• Pentostatin (administration & dosage)
• Rituximab (administration & dosage)
• Treatment Outcome