Real world data on follicular lymphoma patients treated by rituximab-containing immunochemotherapy and rituximab maintenance

• Main Authors: Hee Kyung Kim, Wonseok Kang, Dong Hyun Sinn, Joon Hyeok Lee, Won Seog Kim, Seok Jin Kim
• Format: Article
• Language: English
• Published: The Korean Association of Internal Medicine 2020-01-01
• Series: The Korean Journal of Internal Medicine
• Subjects: lymphoma, follicula; rituximab; hepatitis b; immunochemotherapy
• Online Access: http://www.kjim.org/upload/pdf/kjim-2018-196.pdf

Background/Aims Real-world data about the treatment outcomes of patients receiving rituximab-containing immunochemotherapy followed by rituximab maintenance are required to understand better the treatment for follicular lymphoma (FL). Methods A cross-sectional study analyzed FL patients who were treated with R-CVP (rituximab, cyclophosphamide, vincristine, and prednisone) or R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) and rituximab maintenance. Results Of 139 patients, 85 patients received R-CVP and 54 received R-CHOP. The characteristics did not differ significantly between the groups. Only grade 3 of FL was more common in R-CHOP. The complete response rate did not differ significantly between R-CHOP (50/54, 92.6%) and R-CVP (77/85, 90.6%). The number of disease relapses during rituximab maintenance did not differ significantly between the groups (p = 0.798). Therefore, the comparison of progression-free survival (PFS) showed no significant difference: the 3-year PFS rates for R-CVP and R-CHOP were 77% and 85%, respectively (p = 0.567). Although five of 56 hepatitis B virus (HBV) core antibody (anti-HBc)-positive patients experienced HBV reactivation, all cases of HBV reactivation were identified during regular monitoring for HBV DNA in blood, and were successfully managed with antiviral treatment. Conclusions The survival outcomes of FL patients on rituximab maintenance after responding to R-CVP or R-CHOP were similar. Rituximab-containing immunochemotherapy followed by rituximab maintenance can be safely used for anti-HBc-positive patients if HBV DNA titer in blood can be regularly monitored.