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Real world data on follicular lymphoma patients treated by rituximab-containing immunochemotherapy and rituximab maintenance

Korean Journal of Internal Medicine 2020년 35권 1호 p.194 ~ 204
김희경 ( Kim Hee-Kyung ) - Chungbuk National University Hospital Department of Internal Medicine

강원석 ( Kang Won-Seok ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
신동현 ( Sinn Dong-Hyun ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
이준혁 ( Lee Joon-Hyeok ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
김원석 ( Kim Won-Seog ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
김석진 ( Kim Seok-Jin ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine

Abstract


Background/Aims: Real-world data about the treatment outcomes of patients receiving rituximab-containing immunochemotherapy followed by rituximab maintenance are required to understand better the treatment for follicular lymphoma (FL).

Methods: A cross-sectional study analyzed FL patients who were treated with R-CVP (rituximab, cyclophosphamide, vincristine, and prednisone) or R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) and rituximab maintenance.

Results: Of 139 patients, 85 patients received R-CVP and 54 received R-CHOP. The characteristics did not differ significantly between the groups. Only grade 3 of FL was more common in R-CHOP. The complete response rate did not differ significantly between R-CHOP (50/54, 92.6%) and R-CVP (77/85, 90.6%). The number of disease relapses during rituximab maintenance did not differ significantly between the groups (p = 0.798). Therefore, the comparison of progression-free survival (PFS) showed no significant difference: the 3-year PFS rates for R-CVP and R-CHOP were 77% and 85%, respectively (p = 0.567). Although five of 56 hepatitis B virus (HBV) core antibody (anti-HBc)-positive patients experienced HBV reactivation, all cases of HBV reactivation were identified during regular monitoring for HBV DNA in blood, and were successfully managed with antiviral treatment.

Conclusions: The survival outcomes of FL patients on rituximab maintenance after responding to R-CVP or R-CHOP were similar. Rituximab-containing immunochemotherapy followed by rituximab maintenance can be safely used for anti-HBc-positive patients if HBV DNA titer in blood can be regularly monitored.

키워드

Lymphoma, follicula; Rituximab; Hepatitis B; Immunochemotherapy
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