Rituximab-containing reduced-intensity conditioning improves progression-free survival following allogeneic transplantation in B cell non-Hodgkin lymphoma. Journal of hematology & oncology Epperla, N. n., Ahn, K. W., Ahmed, S. n., Jagasia, M. n., DiGilio, A. n., Devine, S. M., Jaglowski, S. n., Kennedy, V. n., Rezvani, A. R., Smith, S. M., Sureda, A. n., Fenske, T. S., Kharfan-Dabaja, M. A., Armand, P. n., Hamadani, M. n. 2017; 10 (1): 117


In B cell non-Hodgkin lymphoma (B-NHL), rituximab-containing reduced-intensity conditioning regimens (R-RIC) have been shown to provide favorable outcomes in single-arm studies; however, large multicenter studies comparing R-RIC and non-rituximab-containing reduced-intensity conditioning regimens (nonR-RIC) have not been performed. Using the CIBMTR database, we report the outcomes of R-RIC versus nonR-RIC regimens in B-NHL.We evaluated 1401 adult B-NHL patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) who received nonR-RIC (n?=?1022) or R-RIC (n?=?379) regimens. Graft-versus-host disease (GVHD) prophylaxis was limited to calcineurin inhibitor-based approaches.Median follow-up of survivors in the R-RIC and nonR-RIC groups was 47 and 37 months, respectively. On multivariate analysis, no difference was seen between the R-RIC and nonR-RIC cohorts in terms of acute GVHD grade II-IV (RR?=?1.14, 95%CI?=?0.83-1.56, p?=?0.43) or grade III-IV (RR?=?1.16, 95%CI?=?0.72-1.89, p?=?0.54), chronic GVHD (RR?=?1.15, 95%CI?=?0.92-1.46, p?=?0.22), non-relapse mortality (RR?=?0.90; 95%CI?=?0.67-1.22; p?=?0.51), relapse/progression (RR?=?0.79; 95%CI?=?0.63-1.01; p?=?0.055), and mortality (RR?=?0.84, 95%CI?=?0.69-1.02, p?=?0.08) risk. However, R-RIC was associated with a significantly improved progression-free survival (RR?=?0.76; 95%CI 0.62-0.92; p?=?0.006). On subgroup analysis, mortality benefit was noted in the R-RIC group patients not receiving busulfan-based RIC (RR?=?0.76; 95%CI?=?0.60-0.96; p?=?0.02) and with the use of a higher cumulative rituximab dose (RR?=?0.43; 95%CI?=?0.21-0.90; p?=?0.02).Our analysis shows that inclusion of rituximab in RIC regimens improves progression-free survival in patients with B cell NHL. These data supports the use of R-RIC in B-NHL patients undergoing allo-HCT.

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