Efficacy
In the study by Kalpadakis et al. (n=106) in splenic marginal zone lymphoma, the overall response rate (ORR) at the end of induction with rituximab was 92%, with 44% complete response (CR), 21% unconfirmed CR and 27% partial response (PR) rates, with a median time to haematological response of 2 weeks and clinical response of 4 weeks. After a median follow-up of 57 months, the median 5 and 10-year OS were 93% and 85%. The corresponding progression-free survival (PFS) was 71% and 64%. Maintenance was associated with improved PFS but not overall survival (OS). There is no difference in PFS between those who received maintenance for 1 versus 2 years.r
In the earlier analysis by Kalpadakis et al., outcomes of patients with symptomatic splenic marginal zone lymphoma treated with single-agent rituximab (n=58) or splenectomy (n=27) were compared. The ORR to rituximab was 95% (45% CR, 26% unconfirmed CR, 24% PR). At a median follow-up of 3 years, the 5-year OS and PFS rates were 92% and 77%, respectively. Splenectomy resulted in ORR of 85% and 5-year OS and PFS rates of 77% and 58%, respectively.r
In a single institution retrospective analysis by Tsimberidou et al., patients with symptomatic splenic marginal zone lymphoma were treated with rituximab alone (n=26), chemotherapy alone (n=11) or rituximab plus chemotherapy (n=6). When compared to those who received chemotherapy alone, patients who had single-agent rituximab had superior rates of OS (88% vs 55%), 3-year OS (86% vs 45%) and 3-year failure-free survival (86% vs 45%). Outcomes in patients who received both rituximab and chemotherapy were similar to those who received rituximab alone.r
Else et al. retrospectively assessed 43 patients from two centres who received rituximab for splenic marginal zone lymphoma, either alone or with chemotherapy. Rituximab monotherapy appears equally as effective as rituximab chemotherapy combination (90% CR vs 79% CR).r