Impact of rituximab on treatment outcomes of patients with angioimmunoblastic T-cell lymphoma: a population-based analysis

Frederik O. Meeuwes, Mirian Brink, Marjolein W.M. van der Poel, Marie José Kersten, Mariëlle Wondergem, Pim G.N.J. Mutsaers, Lara Böhmer, Sherida Woei-A-Jin, Otto Visser, Rimke Oostvogels, Patty M. Jansen, Arjan Diepstra, Tjeerd J.F. Snijders, Wouter J. Plattel, Gerwin A. Huls, Joost S.P. Vermaat, Marcel Nijland*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: Patients with angioimmunoblastic T-cell lymphoma (AITL) are treated with cyclophosphamide, doxorubicin, vincristine and prednisone with or without etoposide (CHO(E)P). In the majority of cases, Epstein–Barr virus (EBV)-positive B-cells are present in the tumour. There is paucity of research examining the effect of rituximab when added to CHO(E)P. In this nationwide, population-based study, we analysed the impact of rituximab on overall response rate (ORR), progression-free survival (PFS) and overall survival (OS) of patients with AITL. Methods: Patients with AITL diagnosed between 2014 and 2020 treated with ≥one cycle of CHO(E)P with or without rituximab were identified in the Netherlands Cancer Registry. Survival follow-up was up to 1st February 2022. Baseline characteristics, best response during first-line treatment and survival were collected. PFS was defined as the time from diagnosis to relapse or to all-cause-death. OS was defined as the time from diagnosis to all-cause-death. Multivariable analysis for the risk of mortality was performed using Cox regression. Findings: Out of 335 patients, 146 patients (44%) received R–CHO(E)P. Rituximab was more frequently used in patients with a B-cell infiltrate (71% versus 89%, p < 0·01). The proportion of patients who received autologous stem cell transplantation (ASCT) was similar between CHO(E)P and R–CHO(E)P (27% versus 30%, respectively). The ORR and 2-year PFS for patients who received CHO(E)P and R–CHO(E)P were 71% and 78% (p = 0·01), and 40% and 45% (p = 0·12), respectively. The 5-year OS was 47% and 40% (p = 0·99), respectively. In multivariable analysis, IPI-score 3–5, no B-cell infiltrate and no ASCT were independent prognostic factors for risk of mortality, whereas the use of rituximab was not. Interpretation: Although the addition of rituximab to CHO(E)P improved ORR for patients with AITL, the PFS and OS did not improve.

Original languageEnglish
Pages (from-to)100-109
Number of pages10
JournalEuropean Journal of Cancer
Publication statusPublished - 1 Nov 2022

Bibliographical note

The authors would like to thank the registrars of the Netherlands Cancer Registry (NCR) for their dedicated data collection. The nationwide population-based NCR is maintained and hosted by the Netherlands Comprehensive Cancer Organisation (IKNL).

Publisher Copyright: © 2022 The Author(s)


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