Dr. Kaplan Discusses Rituximab Maintenance in MCL

Lawrence D. Kaplan, MD, clinical professor of medicine, director, Adult Lymphoma Program, division of Hematology-Oncology, University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, discusses remaining questions with rituximab (Rituxan) maintenance for patients with mantle cell lymphoma (MCL).

According to Kaplan, a cooperative group trial was activated looking at how minimal residual disease (MRD) predicts for outcome with rituximab maintenance and whether the use of autologous transplant changes that outcome. There have been many studies in MCL suggesting that the MRD level prior to going to transplant is the best predictor of outcome.

A remaining question is, do patients who have had induction therapy and are MRD-negative need a transplant? The LyMa trial randomized those patients to transplant followed by rituximab or rituximab maintenance, explains Kaplan.

The LyMa study demonstrated that maintenance rituximab following autologous stem cell transplantation improved survival in patients with MCL. This phase III trial assigned patients younger than 66 years to maintenance therapy after autologous stem-cell transplantation showing a superior 4-year overall survival and progression free survival compared with patients assigned to observation.