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Annals of Oncology 15:504-510, 2004
© 2004 European Society for Medical Oncology

Original Paper

Efficiency of in vivo purging with rituximab prior to autologous peripheral blood progenitor cell transplantation in B-cell non-Hodgkin’s lymphoma: a single institution study

Received 20 May 2003; revised 1 September 2003; accepted 7 November 2003;

Background:

Rituximab induces clinical response in advanced B-cell lymphoma and is efficient in removing circulating B-cell from peripheral blood. We therefore postulated that rituximab might be a useful in vivo purging agent before high-dose therapy in this setting.

Patients and methods:

Fourteen patients with relapsed follicular, marginal zone and mantle cell lymphomas (11, two and one cases, respectively) and a PCR-detectable molecular marker were treated first with rituximab, then a mobilization chemotherapeutic regimen, followed by high-dose therapy with peripheral blood stem cell transplantation. PCR analyses were performed in peripheral blood before rituximab and during follow-up, and in harvest.

Results:

Harvests were free of PCR-detectable molecular marker in nine of the 11 studied cases (82%). After high-dose therapy, clinical complete remission was obtained in 13 (93%) patients and molecular remission in 11 (79%). With a median follow-up of 3 years, the 14 transplanted patients were alive, 11 of them remaining in clinical complete remission and eight in molecular remission at last follow-up.

Conclusion:

Rituximab treatment followed by high dose therapy appears to be effective in achieving complete clinical and molecular response. In vivo harvest purging is predictive of prolonged clinical and molecular remission.

K. Belhadj1,*, M.-H. Delfau-Larue2, T. Elgnaoui1, F. Beaujean3, J.-L. Beaumont3, C. Pautas1, I. Gaillard1, Y. Kirova4, A. Allain1, P. Gaulard5, J.-P. Farcet2, F. Reyes1 and C. Haioun1

1 CHU Henri Mondor, Service d’Hématologie Clinique; 2 CHU Henri Mondor, Laboratoire d’Immunologie; 3 CHU Henri Mondor, Unité de Thérapie cellulaire EFS; 4 CHU Henri Mondor, Service de Radiothérapie; 5 CHU Henri Mondor, Service d’Anatomo-pathologie, Créteil, France

Key words: B-NHL, high-dose therapy, PCR, purging, rituximab


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