Benefit of rituximab maintenance after first-line bendamustine-rituximab in patients with mantle cell lymphoma

The benefit of rituximab maintenance after first-line (1L) bendamustine-rituximab (BR) in patients with mantle cell lymphoma (MCL) remains uncertain, with inconsistent results from the phase 2 MAINTAIN trial and several retrospective studies. We conducted a large retrospective study at 27 US and Canadian academic centers to examine the benefit of rituximab maintenance after BR. A total of 911 patients received 1L BR between 2010 and 2020, and 703 had an objective response and no evidence of disease progression at the 3-month post-BR landmark. Among those, 394 (56%) received rituximab maintenance and 309 (44%) did not, with largely similar baseline patient and disease characteristics. In the landmark analysis, rituximab maintenance was associated with improved event-free survival (EFS; median, 49.9 vs 29.7 months; P< .001) as well as overall survival (OS; median, 109.5 vs 74.2 months; P< .001). The EFS and OS benefits were observed across most of the subgroups. EFS and OS differences were statistically significant in those who achieved a complete response to 1L BR (n = 590; median EFS, 62.7 vs 31.1 months [P< .001]; median OS, 136.1 vs 75.3 months [P< .001]), but the analysis among those who achieved a partial response to 1L BR was limited by the small sample size. These results provide additional evidence for the survival benefit of rituximab maintenance after BR in MCL and support its use in clinical trial design and routine practice.

Authors

Institutions

Publication Details

Journal
Blood Advances
Published
2025-12-11
DOI
https://doi.org/10.1182/bloodadvances.2025018527
Primary Topic
Lymphoma Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
0.00

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Benefit of rituximab maintenance after first-line bendamustine-rituximab in patients with mantle cell lymphoma

Reem Karmali, Manali Kamdar, Mayur Subhash Narkhede, Brian T. Hill et al.
Blood Advances
Lymphoma Diagnosis and Treatment
article

Benefit of rituximab maintenance after first-line bendamustine-rituximab in patients with mantle cell lymphoma

Reem Karmali, Manali Kamdar, Mayur Subhash Narkhede, Brian T. Hill, Jonathon Brett Cohen, Alexander Stanisic, Ashlee Joseph, Irl Brian Greenwell, Sabarish Ayyappan, Stefan Klaus Barta, Craig Anthony Portell, Lauren Gabriele Banaszak, Kami J. Maddocks, Amitkumar Mehta, Firas Baidoun, Muhamad Alhaj Moustafa, Anthony Stack, Peter Martin, Aung M. Tun, Diego R. Villa, Drew G. Gerber, Izidore S. Lossos, Taylor Brooks, David A. Bond, Marcus Messmer, Georgios Pongas, Javier Muñoz, Jia Ruan, Rahul S. Bhansali, Zoey I. Harris, Imran Nizamuddin, Eric Mou, Tamara Kay Moyo, Matthew J. Maurer, Steven R. Hwang, Laveniya Kugathasan, Reid W. Merryman, Alexey Valeryevich Danilov, Brad S. Kahl, Christine E. Ryan, Nilanjan Ghosh, Natalie Sophia Grover, James R. Cerhan, Patrick M. Reagan, Arash Velayati, Preetesh Jain, Priyanka Avinash Pophali, Anita Kumar, Michael L. Wang, Yucai Wang, Jakubowska Anna, Melissa C. Larson, Philip Young, Nazneen B. Khan, Christine Argao
article en

Abstract

The benefit of rituximab maintenance after first-line (1L) bendamustine-rituximab (BR) in patients with mantle cell lymphoma (MCL) remains uncertain, with inconsistent results from the phase 2 MAINTAIN trial and several retrospective studies. We conducted a large retrospective study at 27 US and Canadian academic centers to examine the benefit of rituximab maintenance after BR. A total of 911 patients received 1L BR between 2010 and 2020, and 703 had an objective response and no evidence of disease progression at the 3-month post-BR landmark. Among those, 394 (56%) received rituximab maintenance and 309 (44%) did not, with largely similar baseline patient and disease characteristics. In the landmark analysis, rituximab maintenance was associated with improved event-free survival (EFS; median, 49.9 vs 29.7 months; P< .001) as well as overall survival (OS; median, 109.5 vs 74.2 months; P< .001). The EFS and OS benefits were observed across most of the subgroups. EFS and OS differences were statistically significant in those who achieved a complete response to 1L BR (n = 590; median EFS, 62.7 vs 31.1 months [P< .001]; median OS, 136.1 vs 75.3 months [P< .001]), but the analysis among those who achieved a partial response to 1L BR was limited by the small sample size. These results provide additional evidence for the survival benefit of rituximab maintenance after BR in MCL and support its use in clinical trial design and routine practice.

Blood AdvancesVol. 10(4)
Northwestern University (US), University of North Carolina at Chapel Hill (US), University of Iowa (US), Fox Chase Cancer Center (US), BC Cancer Agency (CA), City Of Hope National Medical Center (US), Cleveland Clinic (US), Mayo Clinic (US), Memorial Sloan Kettering Cancer Center (US), The University of Texas MD Anderson Cancer Center (US), University of Wisconsin–Madison (US), University of British Columbia (CA), University of Miami (US), Emory University (US), Medical University of South Carolina (US), Washington University in St. Louis (US), Cornell University (US), Columbia University Irving Medical Center (US), Hospital of the University of Pennsylvania (US), Jacksonville College (US), Spinal Cord Injury BC (CA), WinnMed (US), University Medical Center (US), University of Rochester Medical Center (US), University of Alabama at Birmingham (US), NYU Langone Health (US), Charleston Hematology Oncology Associates (US), Levine Cancer Institute (US), University of Wisconsin Carbone Cancer Center (US), University Hospital and Clinics (US), City of Hope (US), Dana-Farber Cancer Institute (US), Mayo Clinic in Arizona (US), Mayo Clinic Hospital (US), University of Kansas Medical Center (US), University of Colorado Cancer Center (US), Mayo Clinic in Florida (US), Sylvester Comprehensive Cancer Center (US), UC Davis Health (US), Weill Cornell Medicine (US), UNC Lineberger Comprehensive Cancer Center, University of Virginia (US), University of Colorado Anschutz Medical Campus (US), The Ohio State University (US), University of Pennsylvania (US), University of Colorado Denver (US)
Bristol-Myers Squibb, Eli Lilly and Company, Pfizer, AstraZeneca, Gilead Sciences, Celgene, Regeneron Pharmaceuticals, TG Therapeutics, BeiGene, Incyte, Seagen, MorphoSys, Ipsen, Genentech, Pharmacyclics, Loxo Oncology
Openalex Percentile: Top 45%
Lymphoma Diagnosis and Treatment
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.