Journal: Blood advances
This multicenter retrospective study evaluated whether rituximab maintenance after first-line bendamustine‑rituximab improves outcomes in mantle cell lymphoma.
Population
- • 911 patients treated with first-line bendamustine‑rituximab between 2010–2020 at 27 academic centers in the US and Canada.
Landmark cohort
- • 703 patients who responded to induction and had no progression 3 months after completing bendamustine‑rituximab.
Treatment groups
- • 394 (56%) received rituximab maintenance.
- • 309 (44%) did not.
- • Baseline characteristics were largely similar between groups.
Key outcomes (landmark analysis at 3 months post‑induction)
Event-free survival (EFS)
- • With maintenance: median 49.9 months.
- • Without maintenance: median 29.7 months.
- • P < .001.
Overall survival (OS)
- • With maintenance: median 109.5 months.
- • Without maintenance: median 74.2 months.
- • P < .001.
Subgroup: complete response to first-line bendamustine‑rituximab (n=590)
- • EFS: 62.7 vs 31.1 months (maintenance vs no maintenance; P < .001).
- • OS: 136.1 vs 75.3 months (P < .001).
Subgroup: partial response
- • Partial response patients were too few for robust conclusions.
Conclusion
In responding mantle cell lymphoma patients after first-line bendamustine‑rituximab, rituximab maintenance was associated with significantly improved event-free and overall survival, with benefits seen across most examined subgroups. The findings support rituximab maintenance as a standard component of care and as a backbone in future trial designs in this setting.