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Annals of Oncology 12:109-114, 2001
© 2001 European Society for Medical Oncology

research-article

Clearing of cells bearing the bcl-2 [t(14;18)] translocation from blood and marrow of patients treated with rituximab alone or in combination with CHOP chemotherapy

M. S. Czuczman1, A. J. Grillo-López2, P. McLaughlin3, C. A. White2, M. Saleh4, L. Gordon5, A. F. LoBuglio4, J. Rosenberg2, B. Alkuzweny2 and D. Maloney6

1Roswell Park Cancer Institute Buffulo, New York
2IDEC Pharmaceuticals Corporation San Diego, Californa
3University of Texas M D Anderson Cancer Center Houston, Texas
4University of Alabama Birmungham, Alabama
5Northwestern University Chicago, Illinois
6Fred Hutchinson Cancer Center Seattle, Washington, USA

M S Czuczman, MD Department of Hematologic Oncology and Bone Marrow Transplantation Roswell Park Cancer Institute Elm and Carlton Streets Buffalo, NY 14263 USA

PURPOSE: Patients who were PCR-positive for B-cell leukemialymphoma 2 (bcl-2) gene rearrangement [t(14,18)] were evaluated for responses to rituximab alone or combined with CHOP.

PATIENTS AND METHODS: Patients had relapsed or refractory low-grade or follicular non-Hodgkin's lymphoma (IWF. A–D) The single-agent trial used 375 mg/m2 weekly x 4, combination therapy included six cycles of CHOP and six 375 mg/m2 infusions of rituximab Bcl-2 analyses of bone marrow (BM) and peripheral blood (PB) samples at base-line and following therapy were performed using a PCR assay

RESULTS:: In the single-agent trial, of 70 patients whose peripheral blood (PB) was bcl-2 positive at baseline, 36 became bcl-2-negative, 13 remained positive, and 21 varied between positive and negative The overall response rates (ORRs) were 72%, 31%, and 57%, respectively Twelve of twenty-two patients with repeat bone marrow (BM) samples were bcl-2- negative three months post-treatment Of 18 patients in the combination trial, 8 were bcl-2 positive in PB and/or BM All of seven patients positive in PB at baseline and six of seven patients positive in BM were negative at the end of therapy, all patients responded to treatment (100% ORR).

CONCLUSIONS: Rituximab, alone or combined with CHOP, eradicated bcl-2 positive cells from PB and BM in over half of the patients treated and was associated with a high overall clinical response rate The impact on disease-free and overall survival awaits long-term follow up

bcl-2 translocation, non-Hodgkin's lymphoma, rituximab


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