Significance of immunotherapy with anti-CD20 rituximab and high-dose chemotherapy with autologous peripheral blood stem-cell transplantation in first-line treatment for mantle-cell lymphoma – centre experience

Overview

Mantle cell lymphoma is a lymphoid neoplasia with unfavorable prognosis, incurable by means of conventional chemotherapy. In 48 patients suffering with this lymphoma an effect of induction chemotherapy (CHOP-21 or intensified anthracyclines-based regimen by Th.Waits in 20/48 patients, CHOP-21 with sequential imunotherapy anti-CD20 rituximab in 18/48 and VAD+chlorambucil in 10/48) and an effect of autologous peripheral blood stem cells transplantation in 19/48 patients were analyzed. Complete remission was more often reached in CHOP induction regimen followed with anti-CD20 immunotherapy in comparison to anthracyclines-based regimens without anti-CD20 or compared to VAD+chlorambucil protocol (77 % vs. 30 % vs. 10 %, p = 0,011). The autologous transplantation further improved the number of complete remissions from 47 % to 94 %. With the median follow-up of 41 (12–116) months, in the whole cohort of patients, 79 % of patients relapsed/progressed with the median time to relaps/progression of 20 (2–66) months, and 59 % of patients died with the median overall survival of 30 (1–81) months. Despite intensified first-line treatment with autologous stem cell transplantation and addition of anti-CD20 immunotherapy, the prognosis of mantle cell lymphoma patients remains poor.

Key words:
mantle cell lymphoma, autologous transplantation, chemotherapy, rituximab