Dr. Hilal Discusses Rituximab Maintenance in Mantle Cell Lymphoma

Talal Hilal, MB, BCh, assistant professor of medicine, Mayo Clinic, discusses the meta-analysis of rituximab (Rituxan) maintenance for patients with mantle cell lymphoma.

In the overall population, there was a benefit in terms of progression-free survival (PFS) and overall survival (OS) in all of the studies. In the prospective studies, the benefit was mainly PFS—there was no OS benefit. Only 3 prospective trials were included in the analysis, and only 1 used transplant. That, says Hilal, is the main driver of OS benefit in these studies.

The retrospective studies have their own limitations, states Hilal. There was a lot of heterogeneity and differences in how patients were treated. In the transplant only group, there were a couple patients who were excluded because they did not undergo transplant. In those studies, there was a PFS benefit as well, but no OS benefit.

Therefore, patients who are young, fit, and eligible for transplant should be started with an induction chemoimmunotherapy that includes cytarabine-based regimens and rituximab maintenance. It is still a question as to whether this regimen is appropriate for older patients and patients who are not eligible for transplant, says Hilal.