Rituximab and lenalidomide for the treatment of relapsed or refractory indolent non-Hodgkin lymphoma: Real-life experience Journal Article
| Authors: | Cassanello, G.; Drill, E.; Rivas-Delgado, A.; Okwali, M.; Isgor, I.; Caron, P. C.; Epstein-Peterson, Z.; Ghione, P.; Hamlin, P. A.; Lue, J. K.; Horwitz, S. M.; Intlekofer, A. M.; Johnson, W.; Kumar, A.; Moskowitz, A. J.; Noy, A.; Owens, C. N.; Palomba, M. L.; Torka, P.; Galera, P.; Zelenetz, A. D.; Salles, G. A.; Falchi, L. |
| Article Title: | Rituximab and lenalidomide for the treatment of relapsed or refractory indolent non-Hodgkin lymphoma: Real-life experience |
| Abstract: | The combination of rituximab and lenalidomide (R-len) stands as an established treatment for relapsed/refractory (R/R) indolent non-Hodgkin lymphoma (iNHL). However, the reproducibility of clinical trial results in routine clinical practice is unknown. To address this gap in knowledge, we reviewed our experience with patients diagnosed with R/R follicular lymphoma (FL) or marginal zone lymphoma (MZL) treated with this combination. Eighty-four patients underwent treatment with R-len, 69 (82%) affected by FL and 15 (18%) by MZL. The median age at the time of treatment initiation was 65 years (range, 39-94), 38 patients (45%) had a pretreatment FLIPI score of 3-5, 19 (23%) had a bulky disease, 29 (37%) had a lymphoma refractory to the last treatment line, while in 20 (24%) cases the disease was refractory to rituximab. The best overall response rate was 82%, and 52% achieved a complete response (CR). The best CR rates for FL and MZL patients were 55% and 40%, respectively. With a median follow-up of 22 months, the median progression-free survival was 22 months (95% confidence interval [CI]: 19-36) and the 2-year overall survival was 83% (95% CI: 74-93). The median duration of CR was 46 months (95% CI: 22-not reached). Factors associated with shorter progression-free survival in multivariate analysis were bulky disease and rituximab refractoriness. The most common adverse events included hematologic toxicity, fatigue and gastrointestinal disorders, such as diarrhea and constipation. Neutropenia and thrombocytopenia were the most common severe toxicities (grade ≥3 in 25% and 4%, respectively). No new safety signals were reported. Real-life results of R-len in patients with R/R iNHL appear consistent with those reported in prospective studies, and further support its use as comparator arm in controlled clinical trials. ©2025 Ferrata Storti Foundation Published. |
| Keywords: | adult; treatment outcome; aged; aged, 80 and over; middle aged; retrospective studies; major clinical study; overall survival; lenalidomide; fatigue; mortality; neutropenia; diarrhea; drug efficacy; drug safety; rituximab; antineoplastic agent; progression free survival; multiple cycle treatment; anemia; thrombocytopenia; antineoplastic combined chemotherapy protocols; peripheral neuropathy; recurrence; drug resistance; drug resistance, neoplasm; retrospective study; alkaline phosphatase; lymphoma, non-hodgkin; recurrent disease; drug therapy; personal experience; follicular lymphoma; lymphoma, follicular; upper respiratory tract infection; non-hodgkin lymphoma; lactate blood level; hypertransaminasemia; high throughput sequencing; very elderly; humans; human; male; female; article; refractory indolent non hodgkin lymphoma |
| Journal Title: | Haematologica |
| Volume: | 110 |
| Issue: | 2 |
| ISSN: | 0390-6078 |
| Publisher: | Ferrata Storti Foundation |
| Date Published: | 2025-02-01 |
| Start Page: | 439 |
| End Page: | 447 |
| Language: | English |
| DOI: | 10.3324/haematol.2024.285600 |
| PUBMED: | 39234863 |
| PROVIDER: | scopus |
| PMCID: | PMC11788635 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Lorenzo Falchi -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
Related MSK Work