The Phase III international PRIMA trial results, presented at the 15th Congress of the European Hematology Association (EHA) taking place from June 10 to 13 at the Fira Barcelona Gran Via in Barcelona, Spain, show that two years of rituximab ?maintenance? therapy reduced the risk of follicular lymphoma recurrence by 50% in patients who responded to initial chemotherapy plus rituximab induction. Maintenance therapy is a longer-term treatment given after patients achieve remission, with the goal of prolonging the remission.

Lymphoma is a type of cancer involving cells of the immune system, called lymphocytes. Just as cancer represents many different diseases, lymphoma represents many different cancers of lymphocytes – about 35 different subtypes. Follicular lymphoma generally comprises about 20% of all diagnosed lymphoid cancers and represents the prototype of ‘indolent lymphoma’. Follicular lymphoma is most often discovered as painless lumps (nodes) slowly growing over several months, and the median age of discovery is about 60 years. Although the progression rate varies widely, follicular lymphoma typically progresses slowly and causes few symptoms. Patients with follicular lymphoma usually survive for at least 10 years after diagnosis.

Study results
In this study, patients with primarily advanced stage, slowly growing follicular lymphoma were randomly assigned to receive an additional 2 years of rituximab as maintenance therapy (505 patients) or no therapy (observation group; 513 patients) after reduction or disappearance of their disease was obtained by using rituximab-based combination chemotherapy (induction therapy).

After a median follow-up time of 25 months, disease progression occurred in 18% of the rituximab group compared with 34% of the observation group. The benefits of rituximab maintenance were observed regardless of patients’ stage of remission, age or prior treatment regimen.

Quality of Life
Rituximab maintenance therapy was well tolerated, with the most common side effects being infections (37% for the rituximab group compared with 22% of the observation group). Quality of life was similar between the two groups.

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These data indicate that in follicular lymphoma patients in need of treatment, 2-year rituximab maintenance after immunochemotherapy should now be considered as a new standard.

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