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Leuk Lymphoma. 2016 May;57(5):1094-103. doi: 10.3109/10428194.2015.1079313. Epub 2015 Oct 12.

Impact of rituximab maintenance and maintenance schedule on prognosis in first-line treatment of follicular lymphoma. Retrospective analysis from Czech Lymphoma Study Group (CLSG) database.

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a Department of Internal Medicine, Hematology and Oncology , Masaryk University and University Hospital Brno , Brno , Czech Republic .
b Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University , Brno , Czech Republic .
c Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine , Charles University and Faculty Hospital in Motol , Prague , Czech Republic .
d 1st Department of Medicine, First Medical Faculty , Charles University and General University Hospital , Prague , Czech Republic .
e 4th Department of Internal Medicine, Hematology , Charles University Hospital and Faculty of Medicine , Hradec Králové , Czech Republic .
f Department of Hematology , University Hospital Olomouc , Olomouc , Czech Republic .
g Department of Hematooncology , Charles University and University Hospital Pilsen , Pilsen , Czech Republic .
h Department of Oncology , Hospital Ceske Budejovice , Ceske Budejovice , Czech Republic .
i Department of Clinical Hematology , Teaching Hospital Ostrava , Ostrava , Czech Republic , and.
j Internal Clinic of Haematology, University Hospital Kralovske Vinohrady, Prague, Charles University in Prague , 3rd Faculty of Medicine , Prague , Czech Republic.


Rituximab maintenance (RM) improves time to progression (PFS) in advanced follicular lymphoma (FL), but the impact of various RM schedules remains unknown. This study performed a retrospective evaluation of RM given for up to 2 years vs observation in 319 untreated FL patients (stage II-IV; grade 1-3A) responding to RCHOP induction and a comparison of two different RM schedules (RM8=eight doses given every 3 months and RM12=12 doses given every 2 months). A total of 183 patients received RM and 136 patients were observed; 5-year PFS was better in the RM arm, 74.1% vs 52.3% (p<0.001), which was projected in 5-year OS 93.8% vs 87.5% (p=0.005). However, 5-year PFS was similar in both the RM8 (n=54) and RM12 (n=56) arms. In the first line, RM significantly prolongs PFS and OS in FL, but different RM schedules bring a similar benefit.


Follicular lymphoma; maintenance schedule; prognosis; rituximab

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