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Rituximab, Ara-C, dexamethasone and oxaliplatin (R-ADOx) is effective for treatment of elderly patients with relapsed mantle cell lymphoma

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Abstract

Purpose

The management of patients with mantle cell lymphoma (MCL) not eligible for stem cell transplantation in relapse after receiving standard approaches remains challenging, and the search for active and tolerable regimens is still warranted.

Patients and methods

We have retrospectively analyzed activity of rituximab (375 mg/m2 i.v. day 1), Ara-C (1,000 mg i.v. total twice daily on day 2) and oxaliplatin (130 mg/m2 i.v. day 3) (R-ADOx) in 12 patients (median age 69 years) with relapsed MCL.

Results

Patients had been heavily pretreated (median 3 prior therapies, range 1–9) and had stage III/IV disease. Nine out of 12 patients responded (75 %, 4 CR, 5 PR). Median progression-free survival was 9.3 months, and overall survival has not been reached. Adverse events greater than grade II included anemia (17 %) and thrombocytopenia (33 %).

Conclusion

R-ADOx is active and well tolerated in heavily pretreated MCL patients.

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References

  • Ansell SM, Inwards DJ, Rowland KM Jr, Flynn PJ, Morton RF, Moore DF Jr, Kaufmann SH, Ghobrial I, Kurtin PJ, Maurer M, Allmer C, Witzig TE (2008) Low-dose, single-agent temsirolimus for relapsed mantle cell lymphoma: a phase 2 trial in the North Central Cancer Treatment Group. Cancer 113:508–514

    Article  PubMed  CAS  Google Scholar 

  • Barista I, Romaguera JE, Cabanillas F (2001) Mantle cell lymphoma. Lancet Oncol 2(3):141–148 (Erratum in: Lancet Oncol 2(4): 198. Lancet Oncol 2002; 3:396)

  • Eve HE, Carey S, Richardson SJ, Heise CC, Mamidipudi V, Shi T, Radford JA, Auer RL, Bullard SH, Rule SA (2012) Single-agent lenalidomide in relapsed/refractory mantle cell lymphoma: results from a UK phase II study suggest activity and possible gender differences. Br J Haematol 159:1541–1563

    Article  Google Scholar 

  • Geisler CH, Kolstad A, Laurell A, Andersen NS, Pedersen LB, Jerkeman M, Nordic Lymphoma Group (2008) Mantle cell lymphoma can be cured by intensive immunochemotherapy with in vivo purged stem-cell support; final report of the Nordic Lymphoma Group MCL2 study. Blood 112:2687–2693

    Article  PubMed  CAS  Google Scholar 

  • Hess G, Herbrecht R, Romaguera J, Verhoef G, Crump M, Gisselbrecht C, Laurell A, Offner F, Strahs A, Berkenblit A, Hanushevsky O, Clancy J, Hewes B, Moore L, Coiffier B (2009) Phase III study to evaluate temsirolimus compared with investigator’s choice therapy for the treatment of relapsed or refractory mantle cell lymphoma. J Clin Oncol 27:3822–3829

    Article  PubMed  CAS  Google Scholar 

  • Hitz F, Martinelli G, Zucca E, von Moos R, Mingrone W, Simcock M, Peterson J, Cogliatti SB, Bertoni F, Zimmermann DR, Ghielmini M, Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland.; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland (2009) A multicentre phase II trial of gemcitabine for the treatment of patients with newly diagnosed, relapsed or chemotherapy resistant mantle cell lymphoma: SAKK 36/03. Hematol Oncol 27:154–159

    Article  PubMed  CAS  Google Scholar 

  • Kluin-Nelemans HC, Hoster E, Hermine O, Walewski J, Trneny M, Geisler CH, Stilgenbauer S, Thieblemont C, Vehling-Kaiser U, Doorduijn JK, Coiffier B, Forstpointner R, Tilly H, Kanz L, Feugier P, Szymczyk M, Hallek M, Kremers S, Lepeu G, Sanhes L, Zijlstra JM, Bouabdallah R, Lugtenburg PJ, Macro M, Pfreundschuh M, Procházka V, Di Raimondo F, Ribrag V, Uppenkamp M, André M, Klapper W, Hiddemann W, Unterhalt M, Dreyling MH (2012) Treatment of older patients with mantle cell lymphoma. N Engl J Med 367:520–531

    Article  PubMed  CAS  Google Scholar 

  • Lamm W, Kaufmann H, Raderer M, Hoffmann M, Chott A, Zielinski CC, Drach J (2011) Bortezomib combined with rituximab and dexamethasone is an active regimen for patients with relapsed and chemotherapy-refractory mantle cell lymphoma. Haematologica 96:1008–1014

    Article  PubMed  CAS  Google Scholar 

  • Lenz G, Dreyling M, Hoster E, Wörmann B, Dührsen U, Metzner B, Eimermacher H, Neubauer A, Wandt H, Steinhauer H, Martin S, Heidemann E, Aldaoud A, Parwaresch R, Hasford J, Unterhalt M, Hiddemann W (2005) Immunochemotherapy with rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone significantly improves response and time to treatment failure, but not long-term outcome in patients with previously untreated mantle cell lymphoma: results of a prospective randomized trial of the German Low Grade Lymphoma Study Group (GLSG). J Clin Oncol 23:1984–1992

    Article  PubMed  CAS  Google Scholar 

  • Rigacci L, Puccini B, Cortelazzo S, Gaidano G, Piccin A, D’Arco A, Freilone R, Storti S, Orciuolo E, Zinzani PL, Zaja F, Bongarzoni V, Balzarotti M, Rota-Scalabrini D, Patti C, Gobbi M, Carpaneto A, Liberati AM, Bosi A, Iannitto E (2012) Bendamustine with or without rituximab for the treatment of heavily pretreated non-Hodgkin’s lymphoma patients: a multicenter retrospective study on behalf of the Italian Lymphoma Foundation (FIL). Ann Hematol 91:1013–1022

    Article  PubMed  CAS  Google Scholar 

  • Ruan J, Martin P, Coleman M, Furman RR, Cheung K, Faye A, Elstrom R, Lachs M, Hajjar KA, Leonard JP (2010) Durable responses with the metronomic rituximab and thalidomide plus prednisone, etoposide, procarbazine, and cyclophosphamide regimen in elderly patients with recurrent mantle cell lymphoma. Cancer 116:2655–2664

    Article  PubMed  CAS  Google Scholar 

  • Visco C, Finotto S, Zambello R, Paolini R, Menin A, Zanotti R, Zaja F, Semenzato G, Pizzolo G, D’Amore ES, Rodeghiero F (2013) Combination of Rituximab, Bendamustine, and Cytarabine for patients with mantle-cell non-hodgkin lymphoma ineligible for intensive regimens or autologous transplantation. J Clin Oncol 11. [Epub ahead of print]

  • Wang M, Fayad L, Wagner-Bartak N, Zhang L, Hagemeister F, Neelapu SS, Samaniego F, McLaughlin P, Fanale M, Younes A, Cabanillas F, Fowler N, Newberry KJ, Sun L, Young KH, Champlin R, Kwak L, Feng L, Badillo M, Bejarano M, Hartig K, Chen W, Chen Y, Byrne C, Bell N, Zeldis J, Romaguera J (2012a) Lenalidomide in combination with rituximab for patients with relapsed or refractory mantle-cell lymphoma: a phase 1/2 clinical trial. Lancet Oncol 13:716–723

    Article  PubMed  Google Scholar 

  • Wang M, Rule SA, Martin P, Goy A, Auer R, Kahl BS, Jurczak W, Advani RH, Romaguera JE, Jesse McGreivy J, Clow F, Stevens-Brogan M, Kunkel L, Blum KA (2012) Interim results of an international, multicenter, phase 2 study of Bruton’s Tyrosine Kinase (BTK) Inhibitor, Ibrutinib (PCI-32765), in relapsed or refractory mantle cell lymphoma (MCL): durable efficacy and tolerability with longer follow-up. oral presentation at the 54th ASH annual meeting and exposition, Atlanta, GA, December 8–12

  • Woehrer S, Hejna M, Skrabs C, Drach J, Zielinski CC, Jaeger U, Raderer M (2005) Rituximab, Ara-C, dexamethasone and oxaliplatin is safe and active in heavily pretreated patients with diffuse large B-cell lymphoma. Oncology 69:499–502

    Article  PubMed  Google Scholar 

  • Zinzani PL, Pellegrini C, Merla E, Ballerini F, Fabbri A, Guarini A, Guarini A, Pavone V, Quintini G, Puccini B, Vigliotti ML, Stefoni V, Derenzini E, Broccoli A, Gandolfi L, Quirini F, Casadei B, Argnani L, Baccarani M (2012) Bortezomib as salvage treatment for heavily pretreated relapsed lymphoma patients: a multicenter retrospective study. Hematol Oncol. doi:10.1002/hon.2036. [Epub ahead of print]

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Correspondence to Markus Raderer.

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Lamm, W., Drach, J., Kiesewetter, B. et al. Rituximab, Ara-C, dexamethasone and oxaliplatin (R-ADOx) is effective for treatment of elderly patients with relapsed mantle cell lymphoma. J Cancer Res Clin Oncol 139, 1771–1775 (2013). https://doi.org/10.1007/s00432-013-1475-4

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  • DOI: https://doi.org/10.1007/s00432-013-1475-4

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