González Barca, EvaDomingo Domènech, EvaCapote, Francisco JavierGómez Codina, JoseSalar, AntonioBailen, AliciaRibera, Josep MariaLópez, AndresBriones, JavierMuñoz, AndresEncuentra, MaiteFernández de Sevilla Ribosa, AlbertoGELTAMO (Grupo Español de Linfomas y Trasplantes de Médula Ósea)GELCAB (Grupo para el Estudio de los Linfomas Catalano-Balear)GOTEL (Grupo Oncológico para el Tratamiento y Estudio de los Linfomas)2019-01-252019-01-2520070390-6078https://hdl.handle.net/2445/127596Background and Objectives The elective treatment of patients with post-transplant lymphoproliferative disorders is controversial. The purpose of this trial was to evaluate the efficacy of treatment with extended doses of rituximab adapted to the response in patients with post-transplant lymphoproliferative disorders after solid organ transplantation. Design and Methods This was a prospective, multicenter, phase 11 trial. Patients were treated with reduction of immunosuppression and four weekly infusions of rituximab. Those patients who did not achieve complete remission (CR) received a second course of four rituximab infusions. The primary end-point of the study was the CR rate. Results Thirty-eight patients were assesable. One episode of grade 4 neutropenia was the only severe adverse event observed. After the first course of rituximab, 13 (34.2%) patients achieved CR, 8 patients did not respond, and 17 patients achieved partial remission. Among those 17 patients, 12 could be treated with a second course of rituximab, and 10 (83.3%) achieved CR, yielding an intention-to-treat CR rate of 60.5%. Eight patients excluded from the trial because of absence of CR were treated with rituximab combined with chemotherapy, and six (75%) achieved CR. Event-free survival was 42% and overall survival was 47% at 27.5 months. Fourteen patients died, ten of progression of their post-transplant lymphoproliferative disorder. Interpretation and Conclusions These results confirm that extended treatment with rituximab can obtain a high rate of CR in patients with post-transplant lymphoproliferative disorders after solid organ transplantation without increasing toxicity, and should be recommended as initial therapy for these patients.6 p.application/pdfengcc-by-nc (c) Ferrata Storti Foundation, 2007http://creativecommons.org/licenses/by-nc/3.0/esLimfomesMalalties hematològiquesPronòstic mèdicTerapèuticaLymphomasHematologic diseasesPrognosisTherapeuticsinfo:eu-repo/semantics/article5578042019-01-25info:eu-repo/semantics/openAccess