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A retrospective study on the management of patients with rituximab refractory follicular lymphoma

Abstract : Given that there are currently no clear recommendations regarding therapeutic options for rituximab refractory/relapsed follicular lymphoma patients, this study aimed to describe the real-life management of patients with refractory follicular lymphoma after systemic rituximab-containing regimens (rFL), and rFL patient characteristics. In this retrospective, national, multicentre study, descriptive analyses were mainly performed according to rituximab-containing regimen at rFL diagnosis [rituximab monotherapy (R-MONO), rituximab + chemotherapy (R-COMBO), and ongoing rituximab maintenance (R-MAINTAIN)]. The 459 analysed patients experienced rituximab-refractoriness between October 2013 and September 2015 R-MONO 58 (13%), R-COMBO 197 (43%), R-MAINTAIN 204 (44%). Post-refractoriness strategies were heterogeneous idelalisib ± rituximab (22%), without anti-lymphoma treatment (21%), rituximab-chemotherapy (21%) and stem cell transplantation (18%). Rituximab was continued in combination in 41% of cases. Chosen strategies varied according to patient age (without anti-lymphoma treatment 28% of patients if ≥65 years vs. 12% if <65 years old; stem-cell transplantation 4% vs. 38%), treatment line at rFL, FL International Prognostic Index score and prior treatment. This French retrospective study, the first one conducted in a large cohort of rFL patients, showed that further strategies were highly heterogeneous, depending notably on patient characteristics and previous treatment. These data are the basis for a better understanding of rFL management and for the design of clinical trials in these patients.
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Submitted on : Thursday, July 25, 2019 - 1:55:53 PM
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Philippe Solal-Céligny, Pierre Leconte, Aurélie Bardet, Juana Hernandez, Xavier Troussard. A retrospective study on the management of patients with rituximab refractory follicular lymphoma. British Journal of Haematology, Wiley, 2018, 180 (2), pp.217-223. ⟨10.1111/bjh.15023⟩. ⟨hal-02194318⟩



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