Rituximab Maintenance After ASCT Yields Long-Term Benefits for Patients With Mantle Cell Lymphoma

Findings from a 7.5-Year Follow-Up of the LYMA Trial

According to a 7.5-year follow-up of the LYMA trial published in the Journal of Clinical Oncology, standard-of-care therapy of rituximab maintenance following autologous stem cell transplantation (ASCT) continued to demonstrate benefits to efficacy and safety outcomes among first-line young patients with mantle cell lymphoma (MCL). 

In this long-term follow-up, Clémentine Sarkozy, MD, PhD, Institut Curie, Saint Cloud, France, and coauthors aimed to assess the continuous efficacy and safety of this regimen among patients with MCL after a median of 7.5 years. 

Results indicated that the median progression-free survival (PFS) and overall survival were unable to be reached among the full population of patients. Event-free survival continued to be statistically superior among patients who were administered rituximab maintenance, with a 7-year estimated event-free survival of 76.2% among the rituximab maintenance group and 46% among the observation group. 

Similarly, rituximab maintenance prolonged PFS, which was estimated at 7 years to be 78.5% among the rituximab maintenance group and 47.4% among the observation group. The estimated 7-year overall survival was 83.2% among the rituximab maintenance group compared with 72.2% among the observational group. 

In terms of safety, the causes of death were comparable across groups. The leading cause of death was lymphoma, and the study authors noted that there was a very low rate of infection-related death. 

Based on these long-term findings, Dr Sarkozy et al concluded, “the PFS benefit of [rituximab maintenance] after autologous stem cell transplantation remains after 7-year follow-up, and [rituximab maintenance] was not associated with an increase in infection-related mortality, making this strategy a safe standard of care with long-term follow-up.” 

Source: 

Sarkozy C, Thieblemont C, Oberic L, et al. Long-term follow-up of rituximab maintenance in young patients with mantle-cell lymphoma included in the LYMA trial: a LYSA study. J Clin Oncol. Published online: December 18, 2023. doi: 10.1200/JCO.23.0158