Rituximab in combination with adapted-dose of ifosfamide and etoposide as salvage treatment in elderly refractory/relapsed diffuse large B-cell lymphoma patients non-candidate for high dose therapy: a retrospective study

Abstract

We retrospectively reviewed for 72 relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) patients ineligible for autologous stem-cell transplantation (ASCT) treated between 2004 and 2017, efficacy and safety profile of rituximab (375 mg/m²) in combination with etoposide (300 mg/m²) and ifosfamide (1500 mg/m²) at 2, 3, or 4-week intervals. Median age was 79 years (range, 64–92). The median number of previous line was 1 (range 1–8). Patients received a median of six cycles (1–12). Fourteen patients (19%) presented partial and 14 complete responses (19%). Among the 369 cycles, nine patients developed febrile neutropenia (13%), 14 a grade 3–4 neutropenia (19%), 7 a grade 3–4 thrombocytopenia (10%) without grade 3–4 non-hematological toxicity. With a median follow up of 7.8 months, the median progression-free survival, overall survival, and duration of response were 4.4 months, 9.4 months, and 12 months, respectively. This regimen represents a therapeutic option in R/R DLBCL patients ineligible to ASCT.

Keywords:

• Diffuse large B-cell lymphoma
• relapse
• refractory
• transplantation-ineligible
• salvage therapy
• rituximab–ifosfamide–etoposide

Author contributions

Guillaume Aussedat and Hervé Ghesquières designed the study. Guillaume Aussedat, Delphine Maucort-Boulch, and Hervé Ghesquières interpreted data and wrote the manuscript. Delphine Maucort-Boulch and Mad Helenie Elsensohn performed statistical analyses. Guillaume Aussedat, Bertrand Favier, and Nicolas Vantard collected data. Guillaume Aussedat, Philippe Rey, Violaine Safar, Lionel Karlin, Emmanuel Bachy, Laure Lebras, Dana Ghergus, Camille Golfier, Pierre Sesques, Anne Lazareth, Hélène Lequeu, Emmanuelle Ferrant, Gilles Salles, Emmanuelle Nicolas-Virelizier, and Hervé Ghesquieres provided data. All authors reviewed the manuscript and approved the final version.

Disclosure statement

The authors reported no potential conflict of interest.