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Blood, 15 December 2006, Vol. 108, No. 13, pp. 4003-4008. Prepublished online as a Blood First Edition Paper on August 31, 2006; DOI 10.1182/blood-2006-04-016725. This Article Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2006-04-016725v1 108/13/4003    most recent Alert me when this article is cited Alert me if a correction is posted 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 Forstpointner, R. Articles by Hiddemann, W. Search for Related Content PubMed PubMed Citation Articles by Forstpointner, R. Articles by Hiddemann, W. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted April 21, 2006 Accepted August 1, 2006 Maintenance therapy with rituximab leads to a significant prolongation of response duration after salvage therapy with a combination of rituximab, fludarabine, cyclophosphamide and mitoxantrone (R-FCM) in patients with relapsed and refractory follicular and mantle cell lymphomas - results of a prospective randomized study of the German low grade lymphoma study group (GLSG) Roswitha Forstpointner, Michael Unterhalt, Martin Dreyling, Hans-Peter Bock, Roland Repp, Hannes Wandt, Christiane Pott, John F. Seymour, Bernd Metzner, Annette Hanel, Tanja Lehmann, Frank Hartmann, Hermann Einsele, and Wolfgang Hiddemann* Department of Internal Medicine III, University of Munich, Grobhadern Hamatologisch/Onkologische Praxis, Offenbach Dept. of Internal Medicine III, University of Erlangen, pres. University Hospital Schleswig-Holstein Department of Internal Medicine V, Klinikum Nord, Nurnberg Department of Internal Medicine II, University Hospital Schleswig-Holstein, Campus Kiel Peter MacCallum Cancer Center, Division of Hematology/Oncology, East Melbourne, Australia Department of Internal Medicine II, Oncology and Hematology, Klinikum Oldenburg Department of Internal Medicine III, Klinikum Chemnitz Department of Hematology, Oncology and Tumorimmunology, HELIOS Klinikum Berlin-Buch Department of Internal Medicine I, University of Homburg/Saar Department of Internal Medicine, University of Wurzburg * Corresponding author; email: wolfgang.hiddemann{at}med.uni-muenchen.de. In follicular lymphoma (FL) and mantle cell lymphoma (MCL) the monoclonal antibody Rituximab (R) improves the prognosis when combined with chemotherapy. The present study investigated R-maintenance after R-chemotherapy. Patients with relapsed or refractory FL and MCL were randomized to 4 courses of fludarabine, cyclophosphamide and mitoxantrone (FCM) alone or combined with R (R-FCM). Responding patients underwent a second randomization for R maintenance comprising two further courses of 4 x weekly doses of R after 3 and 9 months. The first randomization was stopped after 147 patients when R-FCM revealed a significantly better outcome. All subsequent patients received R-FCM. 176 patients are currently evaluable 138 of whom received R-FCM for remission induction. Response duration was significantly prolonged by R-maintenance after R-FCM with the median not being reached versus 16 months (p=0.001). This beneficial effect was also observed when analyzing FL (p=0.035) and MCL (p=0.049) separately. Hence, R-maintenance is effective after salvage with R-chemotherapy and significantly prolongs response duration in patients with relapsed or refractory FL or MCL. 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