Prescrire international
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Prescrire international · Mar 2012
Rituximab maintenance therapy of relapsed or refractory follicular lymphoma, with longer follow-up: no proven impact on survival.
Long-term follow-up data from a clinical trial including 334 patients that compared single-agent maintenance therapy with rituximab versus watchful waiting showed no statistically significant increase in survival time among patients with relapsed or refractory follicular lymphoma.
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Prescrire international · Mar 2012
Rituximab maintenance therapy for follicular lymphoma: no better than watchful waiting.
Chemotherapy is the first-choice treatment for patients with advanced follicular lymphoma (Ann Arbor stage III or IV) who qualify for therapy, but there is no consensus protocol. Adding rituximab (Mabthera, Roche) to chemotherapy moderately improves survival time. Rituximab is now authorised for long-term maintenance therapy in patients with follicular lymphoma in whom first-line chemotherapy induces a response. ⋯ Questions still persist abouta possible oncogenic effect. In practice, the benefits of long-term rituximab maintenance therapy after a first line of chemotherapy remain to be demonstrated in terms of the length or quality of survival in patients with follicular lymphoma, while adverse effects are noteworthy. Pending further data, rituximab should only be used in clinical trials in this specific setting.