Skip to main content

Advertisement

SpringerLink
Log in

Follow-up of patients receiving rituximab for diffuse large B cell lymphoma: an overview of systematic reviews

  • Review Article
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Abstract

The advent of rituximab has significantly improved the clinical outcomes of patients with diffuse large B cell lymphoma (DLBCL). Although rituximab is considered safe and effective, data on its long-term use are limited, which suggests that patients should undergo systematic, long-term follow-up aiming to identify delayed or yet undescribed adverse reactions and optimize treatment effectiveness. This study presents an overview of systematic reviews of strategies for follow-up of DLBCL patients receiving rituximab and documents the current state of knowledge on efficacy and safety in this population. A highly sensitive strategy was used to identify systematic reviews of randomized clinical trials (RCTs) in the Cochrane Library, Embase, Lilacs, MEDLINE, and Scirus databases. A handsearch of medical and government agency websites was also conducted. Seven studies were included, among them there were RCTs of patients who used CHOP/CHOP-like chemotherapy plus rituximab for three to eight cycles every 14 to 21 days as induction therapy, whereas some studies used maintenance therapy for 3 to 24 months. Only one study described a follow-up model for management of adverse drug reactions. The benefits of rituximab for induction therapy of DLBCL were demonstrated, although there is no evidence of significant improvement in the overall survival of high-risk patients or those with HIV-related lymphoma. Rituximab therapy was associated with increased rates of fever, infection, and grade 3/4 hematological toxicity, as well as higher infection-related mortality in HIV-positive patients. Although one study addressed the management of adverse reactions to rituximab, our search did not yield any publications on systematic follow-up strategies for these patients. This finding suggests that such instruments should be developed and validated to optimize the effectiveness and long-term safety of novel therapies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Flowers CR, Sinha R, Vose JM (2010) Improving outcomes for patients with diffuse large B cell lymphoma. CA Cancer J Clin 60(6):393–408. doi:10.3322/caac.20087

    PubMed  Google Scholar 

  2. Cultrera JL, Dalia SM (2012) Diffuse large B cell lymphoma: current strategies and future directions. Cancer Control 19(3):204–213

    PubMed  Google Scholar 

  3. Michallet AS, Lebras L, Coiffier B (2012) Maintenance therapy in diffuse large B cell lymphoma. Curr Opin Oncol 24(5):461–465. doi:10.1097/CCO.0b013e3283562036

    Article  PubMed  CAS  Google Scholar 

  4. Bhat SA, Czuczman MS (2009) Novel antibodies in the treatment of non-Hodgkin's lymphoma. Neth J Med 67(8):10

    Google Scholar 

  5. Rituximab: Drug information (2012) Lexicomp. http://www.uptodate.com. Accessed 24 January 2012

  6. Rituximab (2012) DRUGDEX® Evaluations. http://www.thomsonhc.com/hcs/librarian/ND_T/HCS/ND_PR/Main/CS/8AD59B/DUPLICATIONSHIELDSYNC/90024D/ND_PG/PRIH/ND_B/HCS/ND_P/Main/PFDefaultActionId/hcs.main.KeywordSearch.Search. Accessed 24 January 2012

  7. Atmar J (2010) Review of the safety and feasibility of rapid infusion of rituximab. J Oncol Pract 6(2):91–93. doi:10.1200/JOP.200001

    Article  PubMed  Google Scholar 

  8. Pazdur R (2002) Cancer management: a Multidisciplinary Approach: medical, surgical & radiation oncology, 6th edn. Oncology Group, New York

    Google Scholar 

  9. Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 62(10):1006–1012. doi:10.1016/j.jclinepi.2009.06.005

    Article  PubMed  Google Scholar 

  10. Knight C, Hind D, Brewer N, Abbott V (2004) Rituximab (MabThera) for aggressive non-Hodgkin's lymphoma: systematic review and economic evaluation. Health Technol Assess 8(37):iii, ix-xi, 1–82

    CAS  Google Scholar 

  11. Higgins J, Green Se (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]

  12. Gao G, Liang X, Jiang J, Zhou X, Huang R, Chu Z, Zhan Q (2010) A systematic review and meta-analysis of immunochemotherapy with rituximab for B cell non-Hodgkin's lymphoma. Acta Oncol 49(1):3–12. doi:10.3109/02841860903150502

    Article  PubMed  CAS  Google Scholar 

  13. Fang C, Xu W, Li JY (2010) A systematic review and meta-analysis of rituximab-based immunochemotherapy for subtypes of diffuse large B cell lymphoma. Ann Hematol 89(11):1107–1113. doi:10.1007/s00277-010-0990-5

    Article  PubMed  CAS  Google Scholar 

  14. Marti-Carvajal AJ, Cardona AF, Lawrence A (2009) Interventions for previously untreated patients with AIDS-associated non-Hodgkin's lymphoma. Cochrane Database Syst Rev 3, CD005419. doi:10.1002/14651858.CD005419.pub2

    PubMed  Google Scholar 

  15. Murdoch D, Sager J (2008) Will targeted therapy hold its promise? An evidence-based review. Curr Opin Oncol 20(1):104–111. doi:10.1097/CCO.0b013e3282f44b12

    Article  PubMed  CAS  Google Scholar 

  16. Cheung MC, Haynes AE, Meyer RM, Stevens A, Imrie KR (2007) Rituximab in lymphoma: a systematic review and consensus practice guideline from Cancer Care Ontario. Cancer Treat Rev 33(2):161–176. doi:10.1016/j.ctrv.2006.10.005

    Article  PubMed  CAS  Google Scholar 

  17. Feugier P, Van Hoof A, Sebban C, Solal-Celigny P, Bouabdallah R, Ferme C, Christian B, Lepage E, Tilly H, Morschhauser F, Gaulard P, Salles G, Bosly A, Gisselbrecht C, Reyes F, Coiffier B (2005) Long-term results of the R-CHOP study in the treatment of elderly patients with diffuse large B cell lymphoma: a study by the Groupe d'Etude des Lymphomes de l'Adulte. J Clin Oncol 23(18):4117–4126. doi:10.1200/JCO.2005.09.131

    Article  PubMed  CAS  Google Scholar 

  18. Coiffier B, Thieblemont C, Van Den Neste E, Lepeu G, Plantier I, Castaigne S, Lefort S, Marit G, Macro M, Sebban C, Belhadj K, Bordessoule D, Ferme C, Tilly H (2010) Long-term outcome of patients in the LNH-98.5 trial, the first randomized study comparing rituximab-CHOP to standard CHOP chemotherapy in DLBCL patients: a study by the Groupe d'Etudes des Lymphomes de l'Adulte. Blood 116(12):2040–2045. doi:10.1182/blood-2010-03-276246

    Article  PubMed  CAS  Google Scholar 

  19. Rafailidis PI, Kakisi OK, Vardakas K, Falagas ME (2007) Infectious complications of monoclonal antibodies used in cancer therapy: a systematic review of the evidence from randomized controlled trials. Cancer 109(11):2182–2189. doi:10.1002/cncr.22666

    Article  PubMed  CAS  Google Scholar 

  20. Kaplan LD, Lee JY, Ambinder RF, Sparano JA, Cesarman E, Chadburn A, Levine AM, Scadden DT (2005) Rituximab does not improve clinical outcome in a randomized phase 3 trial of CHOP with or without rituximab in patients with HIV-associated non-Hodgkin lymphoma: AIDS-Malignancies Consortium Trial 010. Blood 106(5):1538–1543. doi:10.1182/blood-2005-04-1437

    Article  PubMed  CAS  Google Scholar 

  21. National Comprehensive Cancer Network (2012) Practice guidelines in oncology: non-Hodgkin’s lymphoma, vol 3. NCCN

  22. Tilly H, Dreyling M (2010) Diffuse large B cell non-Hodgkin's lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 21(Suppl 5):v172–v174. doi:10.1093/annonc/mdq203

    Article  PubMed  Google Scholar 

  23. Goldschmidt N, Or O, Klein M, Savitsky B, Paltiel O (2011) The role of routine imaging procedures in the detection of relapse of patients with Hodgkin lymphoma and aggressive non-Hodgkin lymphoma. Ann Hematol 90(2):165–171. doi:10.1007/s00277-010-1044-8

    Article  PubMed  Google Scholar 

  24. Lin TL, Kuo MC, Shih LY, Dunn P, Wang PN, Wu JH, Tang TC, Chang H, Hung YS, Lu SC (2012) Value of surveillance computed tomography in the follow-up of diffuse large B cell and follicular lymphomas. Ann Hematol 91(11):1741–1745. doi:10.1007/s00277-012-1508-0

    Article  PubMed  Google Scholar 

  25. Grazziotin LG, Stoll P, Wust D, Hegele V, Ehrembrick G, Caregnato J, Lindenmeyer L (2012) Systematic review of clinical trials and prospective cohorts: follow up methods in patients with chronic myeloid leukemia treated with dasatinib. 2012 3(12):1000–1012

  26. Jeffery M, Hickey BE, Hider PN (2007) Follow-up strategies for patients treated for non-metastatic colorectal cancer. Cochrane Database Syst Rev (1):CD002200. doi:10.1002/14651858.CD002200.pub2

  27. Renehan AG, Egger M, Saunders MP, O'Dwyer ST (2002) Impact on survival of intensive follow up after curative resection for colorectal cancer: systematic review and meta-analysis of randomised trials. BMJ 324(7341):813

    Article  PubMed  Google Scholar 

  28. Rojas MP, Telaro E, Russo A, Moschetti I, Coe L, Fossati R, Palli D, del Roselli TM, Liberati A (2005) Follow-up strategies for women treated for early breast cancer. Cochrane Database Syst Rev (1):CD001768. doi:10.1002/14651858.CD001768.pub2

  29. Grunfeld E, Levine MN, Julian JA, Coyle D, Szechtman B, Mirsky D, Verma S, Dent S, Sawka C, Pritchard KI, Ginsburg D, Wood M, Whelan T (2006) Randomized trial of long-term follow-up for early-stage breast cancer: a comparison of family physician versus specialist care. J Clin Oncol 24(6):848–855. doi:10.1200/JCO.2005.03.2235

    Article  PubMed  Google Scholar 

  30. Grunfeld E, Gray A, Mant D, Yudkin P, Adewuyi-Dalton R, Coyle D, Cole D, Stewart J, Fitzpatrick R, Vessey M (1999) Follow-up of breast cancer in primary care vs specialist care: results of an economic evaluation. Br J Cancer 79(7–8):1227–1233. doi:10.1038/sj.bjc.6690197

    Article  PubMed  CAS  Google Scholar 

  31. Liekweg A, Westfeld M, Jaehde U (2004) From oncology pharmacy to pharmaceutical care: new contributions to multidisciplinary cancer care. Support Care in Cancer

  32. Ivama AM, Noblat L, de Castro MS, de Oliveira NVBV, Jaramillo NM, Rech N (2002) Consenso Brasileiro de Atenção Farmacêutica, 1st edn. Organização Pan-Americana da Saúde, Brasília

    Google Scholar 

  33. Lash TL, Silliman RA (2001) Medical surveillance after breast cancer diagnosis. Med Care 39(9):945–955

    Article  PubMed  CAS  Google Scholar 

  34. Zuckermann J, Moreira LB, Stoll P, Moreira LM, Kuchenbecker RS, Polanczyk CA (2008) Compliance with a critical pathway for the management of febrile neutropenia and impact on clinical outcomes. Ann Hematol 87(2):139–145. doi:10.1007/s00277-007-0390-7

    Article  PubMed  CAS  Google Scholar 

  35. Li X, Liu Z, Cao J, Hong X, Wang J, Chen F, Wang C, Zou S, Li J, Shen Z (2012) Rituximab in combination with CHOP chemotherapy for the treatment of diffuse large B cell lymphoma in China: a 10-year retrospective follow-up analysis of 437 cases from Shanghai Lymphoma Research Group. Ann Hematol 91(6):837–845. doi:10.1007/s00277-011-1375-0

    Article  PubMed  CAS  Google Scholar 

  36. Viscoli C, Varnier O, Machetti M (2005) Infections in patients with febrile neutropenia: epidemiology, microbiology, and risk stratification. Clin Infect Dis 40(Suppl 4):S240–S245. doi:10.1086/427329

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

This study received financial support from the Brazilian National Health Surveillance (ANVISA).

Conflict of interest

None to declare

Author information

Authors and Affiliations

  1. Estação GHC OTICS Produtos e Serviços, ANVISA Agreement–GHC, Porto Alegre, Brazil

    Luciane Pereira Lindenmeyer, Vanessa Hegele, Diego Wüst & Paula Stoll

  2. Hospital Nossa Senhora da Conceição, Grupo Hospitalar Conceição, Porto Alegre, Rio Grande do Sul, Brazil

    Luciane Pereira Lindenmeyer

  3. School of Pharmacy, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Juliana Prohonoski Caregnato

  4. School of Pharmacy, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Luiza Grazziotin

  5. Av. Francisco Trein, 596, Porto Alegre, Rio Grande do Sul, 91350-200, Brazil

    Luciane Pereira Lindenmeyer

Authors
  1. Luciane Pereira Lindenmeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vanessa Hegele
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Juliana Prohonoski Caregnato
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Diego Wüst
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luiza Grazziotin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paula Stoll
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Luciane Pereira Lindenmeyer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lindenmeyer, L.P., Hegele, V., Caregnato, J.P. et al. Follow-up of patients receiving rituximab for diffuse large B cell lymphoma: an overview of systematic reviews. Ann Hematol 92, 1451–1459 (2013). https://doi.org/10.1007/s00277-013-1811-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00277-013-1811-4

Keywords

Search

Navigation