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Blood, 15 November 2006, Vol. 108, No. 10, pp. 3295-3301. Prepublished online as a Blood First Edition Paper on July 27, 2006; DOI 10.1182/blood-2006-05-021113. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2006-05-021113v1 108/10/3295    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by van Oers, M. H. J. Articles by Hagenbeek, A. Search for Related Content PubMed PubMed Citation Articles by van Oers, M. H. J. Articles by Hagenbeek, A. Related Collections Neoplasia Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Rituximab maintenance improves clinical outcome of relapsed/resistant follicular non-Hodgkin lymphoma in patients both with and without rituximab during induction: results of a prospective randomized phase 3 intergroup trial Marinus H. J. van Oers, Richard Klasa, Robert E. Marcus, Max Wolf, Eva Kimby, Randy D. Gascoyne, Andrew Jack, Mars van't Veer, Andrej Vranovsky, Harald Holte, Martine van Glabbeke, Ivana Teodorovic, Cynthia Rozewicz, and Anton Hagenbeek From the European Organisation for Research and Treatment of Cancer (EORTC) Lymphoma Group, Hemato-Oncologie voor Volwassenen Nederland (HOVON), National Cancer Institute of Canada (NCIC) Clinical Trials Group (CTG) (Canada), British National Lymphoma Investigation (BNLI), Australasian Leukaemia and Lymphoma Group (ALLG), Nordic Lymphoma Group (NLG), and EORTC Data Center. We evaluated the role of rituximab (R) both in remission induction and maintenance treatment of relapsed/resistant follicular lymphoma (FL). A total of 465 patients were randomized to induction with 6 cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) (every 3 weeks) or R-CHOP (R: 375 mg/m2 intravenously, day 1). Those in complete remission (CR) or partial remission (PR) were randomized to maintenance with R (375 mg/m2 intravenously once every 3 months for a maximum of 2 years) or observation. R-CHOP induction yielded an increased overall response rate (CHOP, 72.3%; R-CHOP, 85.1%; P < .001) and CR rate (CHOP, 15.6%; R-CHOP, 29.5%; P < .001). Median progression-free survival (PFS) from first randomization was 20.2 months after CHOP versus 33.1 months after R-CHOP (hazard ratio [HR], 0.65; P < .001). Rituximab maintenance yielded a median PFS from second randomization of 51.5 months versus 14.9 months with observation (HR, 0.40; P < .001). Improved PFS was found both after induction with CHOP (HR, 0.30; P < .001) and R-CHOP (HR, 0.54; P = .004). R maintenance also improved overall survival from second randomization: 85% at 3 years versus 77% with observation (HR, 0.52; P = .011). 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