Effect of the addition of rituximab to salvage chemotherapy prior to autologous stem cell transplant in aggressive CD20+lymphoma: a cohort comparison from the NCIC Clinical Trials Group Study LY.12

The impact of the addition of rituximab to salvage chemotherapy prior to autologous stem cell transplant (ASCT) was evaluated in a retrospective subgroup analysis of NCIC CTG LY. 12. Among 414 patients who relapsed following R-CHOP, 96 received salvage chemotherapy alone [R + cohort]; and 318 received rituximab with chemotherapy [R-cohort] following a protocol amendment. The R-cohort had a higher proportion of patients with PS >= 2 and relapse < 1 year after RCHOP. The response rate (45.6% vs. 25.0%, p = 0.0003), CR/CRu (15.7% vs. 4.2%, p = 0.003) and transplantation rate (51.9% vs. 31.3%, p = 0.0004) was higher in the R-cohort. Event-free (27% vs. 22%, p = 0.0954) and overall survival at four years (43% vs. 31%; p = 0.045) were greater in the R-cohort when the patients with best response SD/PD to R-CHOP were excluded. Addition of rituximab to salvage therapy before ASCT appears to improve the response rate, transplantation rate, and overall survival in patients with CD20+ lymphoma who responded to R-CHOP.