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A phase II trial, led by John D. Hainsworth of the Sarah Cannon Cancer Center and Tennessee Oncology, Nashville , evaluated the efficacy of Rituximab ( MabThera, Rituxan ) with short-duration chemotherapy in the first-line treatment of patients with follicular non-Hodgkin’s lymphoma (NHL).

A total of 86 patients with previously untreated stage II-IV follicular NHL, grade 1 or 2 were enrolled.

All patients received four weekly doses of Rituximab ( 375 mg/m2 intravenous ), followed by three courses of combination chemotherapy , either CHOP or CVP, plus Rituximab.

Eight-two patients ( 95% ) completed treatment; no patient was withdrawn due to toxicity.

The overall response rate was 93%, with 55% complete responses.

The 3- and 4-year actuarial progression-free survivals were 71% and 62%, respectively.

Five patients (6%) died from lymphoma.

Grade 3/4 leukopenia occurred in 53% of patients, but only six patients ( 7% ) had neutropenia or fever.

According to the results of the study Rituximab plus short-course chemotherapy is well tolerated as first-line treatment for patients with follicular non-Hodgkin’s lymphoma.
The overall and complete response rates are similar to those reported with chemotherapy / Rituximab combinations of longer duration.

Rituximab plus short-course chemotherapy may provide an attractive option for first-line treatment of elderly patients and others who tolerate chemotherapy poorly.

Source: Journal of Clinical Oncology, 2005

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