Maintenance rituximab (MR) after autologous stem cell transplant (ASCT) confers a benefit in progression-free survival in patients with mantle cell lymphoma (MCL), but additional studies are required in order to confirm that it confers an overall survival benefit, stated an article published online ahead of print in the Annals of Oncology.1

While high-dose therapy and ASCT improve outcomes for patients with MCL, most patients relapse. For this phase 3 prospective trial, investigators examined a cohort of consecutive patients with MCL that underwent ASCT and evaluated their outcomes according to whether they received MR after ASCT (n=50) or did not (n=107).

Interim results showed that MR was associated with improved progression-free survival (HR, 0.44; 95% CI: 0.24-0.80; P=0.007) and overall survival (HR, 0.46; 95% CI: 0.23-0.93; P=0.03) following a multivariate adjustment for confounding factors with a median follow-up of approximately 5 years.

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In regard to safety, grade 4 neutropenia was increased (34% vs 18%; P=0.04) in the MR group but no effect on the rate of mortality unrelated to relapse was observed.

The authors concluded that “General application of this strategy will require confirmation of benefit in prospective randomized trials.”


  1. Graf SA, Stevenson PA, Holmberg LA, et al. Maintenance rituximab after autologous stem cell transplantation in patients with mantle cell lymphoma. [published online ahead of print September 7, 2015]. Ann Oncol. doi: 10.1093/annonc/mdv364.