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Impact of addition of rituximab to standard treatment in patients with ND Ph+ B-ALL: A retrospective analysis
The potential benefit of adding rituximab to standard chemotherapy and a tyrosine kinase inhibitor in Ph+ B-ALL remains unknown. A retrospective analysis, with the aim of determining the impact of adding rituximab to standard treatment in patients with Ph+ B-ALL, was published in Leukemia & Lymphoma by Rios-Olais et al.1 The cohort included 127 adult patients diagnosed with Ph+ B-ALL (WHO criteria) between January 2009 and December 2023 at five centers in Mexico.1 Patients were grouped into those who were CD20-positive and received rituximab (n = 32), those who were CD20-positive but did not receive rituximab (n = 19), and those who were CD20-negative (n = 76). The primary outcome was 3-month MR4 (≤0.01%) evaluated using RT-qPCR. Secondary outcomes included differences in OS, rates of early mortality, febrile neutropenia, and ICU admissions.1
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Key learnings |
In patients who were CD20-positive, the 3-month MR4 rate was higher in those treated with rituximab compared with those who were not (84% vs 58.9%; OR, 3.66; 95% CI, 1.11–12.08; p = 0.027). |
Median OS was not reached in patients who were CD20-positive and received rituximab compared with 21 months (95% CI, 16.74–25.26) in patients who were CD20-negative and 14 months (95% CI, 10.63–17.37) in those who were CD20-positive but did not receive rituximab. |
No differences were observed in the rates of early mortality (0% vs 4.2%; p = 0.571), febrile neutropenia (62.5% vs 74.7%; p = 0.184), or ICU admission (9.4% vs 10.5%; p = 1.0) between the rituximab and no rituximab cohorts, respectively. |
Addition of rituximab was associated with higher MR4 response rates and improved OS, with no increase in toxicity, in patients with Ph+ B-ALL. Additional prospective studies are required to further explore these findings. |
Abbreviations: B-ALL, B-cell acute lymphoblastic leukemia; CI, confidence interval; HR, hazard ratio; ICU, intensive care unit; MR4, complete molecular response; OR, odds ratio; OS, overall survival; Ph+, Philadelphia chromosome-positive; RT-qPCR, real-time quantitative polymerase chain reaction; WHO, World Health Organization.
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