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Concurrent administration of high-dose chemotherapy and rituximab is a feasible and effective chemo/immunotherapy for patients with high-risk non-Hodgkin's lymphoma

Leukemia volume 15, pages 1941–1949 (2001)Cite this article

Abstract

The aim of this study was to investigate feasibility, tolerability and efficacy of rituximab-supplemented high-dose sequential chemotherapy (R-HDS) with peripheral blood progenitor cell autografting as frontline or salvage treatment in patients with advanced non-Hodgkin's lymphoma (NHL). Thirty-two patients have been treated: 14 at disease onset and 18 with relapsed or progressive disease. R-HDS regimens included six courses of rituximab. Rituximab was delivered either concurrently with high-dose chemotherapy to exploit the in vivo purging properties of the drug as well as at the end of the treatment plan to target minimal residual disease. All patients treated at disease onset completed their treatment with no life-threatening toxicity, while two toxic deaths due to severe bilateral pneumonia were observed among patients treated due to relapsed or refractory disease. Thirteen of 14 patients treated up-front achieved CR. Among pre-treated patients 10 of 18 achieved CR with better results in patients with relapsed (seven of eight) compared to progressive disease (three of 10). PCR analysis was carried out in indolent lymphoma patients: nine of nine follicular lymphomas and three of six CD5-positive NHL collected PCR-negative peripheral blood progenitor cell harvests. The results of this pilot study show that R-HDS is feasible and effective with acceptable toxicity when used at disease onset. In pre-treated patients this treatment also showed promising results, although the risk of severe infections needs to be considered.

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Acknowledgements

This work was supported in part by Consiglio Nazionale delle Ricerche, Rome, Italy (special project ACRO, grant No. 96.00742.PF39 to CT and No. 96.00615.PF39 to AP) and by Associazione Italiana Ricerca sul Cancro, Milan, Italy. SS is a recipient of a fellowship from Comitato Piemontese Gigi Ghirotti. We are grateful to Professor John G Gribben for critical revision of the manuscript.

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  1. Divisione Universitaria di Ematologia – Dipartimento di Medicina ed Oncologia Sperimentale, Università di Torino, Torino, Italy

    M Ladetto, F Zallio, S Vallet, I Ricca, A Cuttica, D Caracciolo, P Corradini, M Astolfi, S Sametti, F Volpato, P Bondesan, M Boccadoro, A Pileri & C Tarella

  2. Bone Marrow Transplantation Unit, Istituto Scientifico HS Raffaele, Milano, Italy

    P Corradini

  3. Divisione di Ematologia, AO San Giovanni Battista della Citta di Torino, Torino, Italy

    U Vitolo

  4. Dipartimento di Oncologia, Università di Milano, Milano, Italy

    AM Gianni

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Ladetto, M., Zallio, F., Vallet, S. et al. Concurrent administration of high-dose chemotherapy and rituximab is a feasible and effective chemo/immunotherapy for patients with high-risk non-Hodgkin's lymphoma. Leukemia 15, 1941–1949 (2001). https://doi.org/10.1038/sj.leu.2402302

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