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01-11-2017 | Review Article

Effect of rituximab on primary central nervous system lymphoma: a meta-analysis

Authors: Yue Song, Yibo Wen, Weili Xue, Yanjie Zhang, Mingzhi Zhang

Published in: International Journal of Hematology | Issue 5/2017

Abstract

The effect of rituximab on primary central nervous system lymphoma (PCNSL) is controversial. We performed this meta-analysis to assess the efficacy of treatment with or without rituximab for PCNSL. We first conducted a search for qualified studies using PubMed, the Cochrane Library, and the Web of Science. The meta-analysis was conducted to compare odds ratios (ORs) with the corresponding 95% confidence interval (95% CI) for complete remission (CR) rate, progression-free survival (PFS), and overall survival (OS) using Review Manager 5.0. We included two randomized clinical trials and six retrospective studies in this meta-analysis. The results of our statistical analysis show that the use of rituximab was closely correlated with a higher CR (OR 1.70, 95% CI 1.17–2.46, P = 0.005), 2-year PFS (OR 2.11, 95% CI 1.08–4.11, P = 0.03), 5-year PFS (OR 2.54, 95% CI 1.64–3.93, P < 0.0001), 2-year OS (OR 2.40, 95% CI 1.73–3.34, P < 0.00001), and 5-year OS (OR 2.87, 95% CI 2.02–4.08, P < 0.00001). These results may help to inform therapeutic strategies including the use of rituximab and to improve therapeutic planning for PCNSL patients.

Batchelor T, Loeffler JS. Primary CNS lymphoma. J Clin Oncol Off J Am Soc Clin Oncol. 2006;24:1281–8.CrossRef

Villano JL, Koshy M, Shaikh H, Dolecek TA, McCarthy BJ. Age, gender, and racial differences in incidence and survival in primary CNS lymphoma. Br J Cancer. 2011;105:1414–8.CrossRefPubMedPubMedCentral

Dolecek TA, Propp JM, Stroup NE, Kruchko C. CBTRUS Statistical Report: primary brain and central nervous system tumors diagnosed in the United States in 2005–2009. NEURO-ONCOLOGY. 2012;145:v1–49.CrossRef

Camilleribroët S, Crinière E, Broët P, Delwail V, Mokhtari K, Moreau A, et al. A uniform activated B-cell-like immunophenotype might explain the poor prognosis of primary central nervous system lymphomas: analysis of 83 cases. Blood. 2006;107:190–6.CrossRef

Braaten KM, Betensky RA, De LL, Okada Y, Hochberg FH, Louis DN, et al. BCL-6 expression predicts improved survival in patients with primary central nervous system lymphoma. Clin Cancer Res Off J Am Assoc Cancer Res. 2003;9:1063.

Rubenstein JL, Combs D, Rosenberg J, Levy A, McDermott M, Damon L, et al. Rituximab therapy for CNS lymphomas: targeting the leptomeningeal compartment. Blood. 2003;101:466–8.CrossRefPubMed

Ewing JR, Brown SL, Lu M, Panda S, Ding GL, Knight RA, et al. Model selection in magnetic resonance imaging measurements of vascular permeability: gadomer in a 9L model of rat cerebral tumor. J Cerebr Blood F Metabol. 2006;26:310–20.CrossRef

Muldoon LL, Soussain C, Jahnke K, Johanson C, Siegal T, Smith QR, et al. Chemotherapy delivery issues in central nervous system malignancy: a reality check. J Clin Oncol. 2007;25:2295–305.CrossRefPubMed

Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17:1–12.CrossRefPubMed

10.

Parent N, Hanley JA. Assessing quality of reports on randomized clinical trials in nursing journals. Can J Cardiovasc Nurs. 2009;19:25–39.PubMed

11.

Wells GA, Shea BJ, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa scale (NOS) for assessing the quality of non-randomized studies in meta-analysis. Appl Eng Agric. 2014;18:727–34.

12.

Parmar MK, Torri V, Stewart L. Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Stat Med. 1998;17:2815.CrossRefPubMed

13.

Tierney JF, Stewart LA, Ghersi D, Burdett S, Sydes MR. Practical methods for incorporating summary time-to-event data into meta-analysis. Trials. 2007;8:16.CrossRefPubMedPubMedCentral

14.

Ferreri AJ, Cwynarski K, Pulczynski E, Ponzoni M, Deckert M, Politi LS, et al. Chemoimmunotherapy with methotrexate, cytarabine, thiotepa, and rituximab (MATRix regimen) in patients with primary CNS lymphoma: results of the first randomisation of the International Extranodal Lymphoma Study Group-32 (IELSG32) phase 2 trial. Lancet Haematol. 2016;3:e217–27.CrossRefPubMed

15.

Luo W, Ji LH, Geng H, Ma XJ, Xiong H, Yin QC, et al. Clinical therapeutic efficacy of rituximab combined with methotrexate on primary central nervous system lymphoma]. Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2016;24:444–7.PubMed

16.

Birnbaum T, Stadler EA, von Baumgarten L, Straube A. Rituximab significantly improves complete response rate in patients with primary CNS lymphoma. J Neurooncol. 2012;109:285–91.CrossRefPubMed

17.

Holdhoff M, Ambady P, Abdelaziz A, Sarai G, Bonekamp D, Blakeley J, et al. High-dose methotrexate with or without rituximab in newly diagnosed primary CNS lymphoma. Neurology. 2014;83:235–9.CrossRefPubMedPubMedCentral

18.

Kansara R, Shenkier TN, Connors JM, Sehn LH, Savage KJ, Gerrie AS, et al. Rituximab with high-dose methotrexate in primary central nervous system lymphoma. Am J Hematol. 2015;90:1149–54.CrossRefPubMed

19.

Mocikova H, Pytlik R, Sykorova A, Janikova A, Prochazka V, Vokurka S, et al. Role of rituximab in treatment of patients with primary central nervous system lymphoma: a retrospective analysis of the Czech lymphoma study group registry. Leukemia Lymphoma. 2016;57:2777–83.CrossRefPubMed

20.

Madle M, Krämer I, Lehners N, Schwarzbich M, Wuchter P, Herfarth K, et al. The influence of rituximab, high-dose therapy followed by autologous stem cell transplantation, and age in patients with primary CNS lymphoma. Ann Hematol. 2015;94:1853–7.CrossRefPubMed

21.

Gregory G, Arumugaswamy A, Leung T, Chan KL, Abikhair M, Tam C, et al. Rituximab is associated with improved survival for aggressive B cell CNS lymphoma. Neuro Oncol. 2013;15:1068–73.CrossRefPubMedPubMedCentral

22.

Ferreri AJ, Reni M, Foppoli M, Martelli M, Pangalis GA, Frezzato M, et al. High-dose cytarabine plus high-dose methotrexate versus high-dose methotrexate alone in patients with primary CNS lymphoma: a randomised phase 2 trial. Lancet. 2009;374:1512–20.CrossRefPubMed

23.

Jezersek NB. Treatment outcomes and survival in patients with primary central nervous system lymphomas treated between 1995 and 2010—a single centre report. Radiol Oncol. 2012;46:346–53.

24.

Cang S, Mukhi N, Wang K, Liu D. Novel CD20 monoclonal antibodies for lymphoma therapy. J Hematol Oncol. 2012;5:64.CrossRefPubMedPubMedCentral

25.

Perez-Callejo D, Gonzalez-Rincon J, Sanchez A, Provencio M, Sanchez-Beato M. Action and resistance of monoclonal CD20 antibodies therapy in B-cell Non-Hodgkin Lymphomas. Cancer Treat Rev. 2015;41:680–9.CrossRefPubMed

26.

Maloney DG, Smith B, Rose A. Rituximab: mechanism of action and resistance. Semin Oncol. 2002;29:2–9.CrossRef

27.

Batchelor TT, Grossman SA, Mikkelsen T, Ye X, Desideri S, Lesser GJ. Rituximab monotherapy for patients with recurrent primary CNS lymphoma. Neurology. 2011;76:929–30.CrossRefPubMedPubMedCentral

28.

Kimby E. Tolerability and safety of rituximab (MabThera (R)). Cancer Treat Rev. 2005;31:456–73.CrossRefPubMed

29.

Plate A, Havla J, Kümpfel T. Late-onset neutropenia during long-term rituximab therapy in neuromyelitis optica. Mult Scler Relat Disord. 2014;3:269–72.CrossRefPubMed

30.

Aksoy S, Harputluoglu H, Kilickap S, Dede DS, Dizdar O, Altundag K, et al. Rituximab-related viral infections in lymphoma patients. Leuk Lymphoma. 2007;48:1307–12.CrossRefPubMed

31.

Tuccori M, Focosi D, Blandizzi C, Pelosini M, Montagnani S, Maggi F, et al. Inclusion of rituximab in treatment protocols for non-Hodgkin’s lymphomas and risk for progressive multifocal leukoencephalopathy. Oncologist. 2010;15:1214–9.CrossRefPubMedPubMedCentral

32.

Akaishi T. Nakashima I [Rituximab (anti-CD20) in neurological disorders]. Brain Nerve. 2014;66:1167–78.PubMed

33.

Gea-Banacloche JC. Rituximab-associated infections. Semin Hematol. 2010;47:187–98.CrossRefPubMed

34.

Engsig FN, Hansen AB, Omland LH, Kronborg G, Gerstoft J, Laursen AL, et al. Incidence, clinical presentation, and outcome of progressive multifocal leukoencephalopathy in HIV-infected patients during the highly active antiretroviral therapy era: a nationwide cohort study. J Infect Dis. 2009;199:77.CrossRefPubMed

35.

Carson KR, Evens AM, Richey EA, Habermann TM, Focosi D, Seymour JF, et al. Progressive multifocal leukoencephalopathy after rituximab therapy in HIV-negative patients: a report of 57 cases from the Research on Adverse Drug Events and Reports project. Blood. 2009;113:4834–40.CrossRefPubMedPubMedCentral

36.

Rubenstein JL, Li J, Chen L, Advani R, Drappatz J, Gerstner E, et al. Multicenter phase 1 trial of intraventricular immunochemotherapy in recurrent CNS lymphoma. Blood. 2013;121:745–51.CrossRefPubMedPubMedCentral

37.

Pels H, Schulz H, Manzke O, Hom E, Thall A, Engert A. Intraventricular and intravenous treatment of a patient with refractory primary CNS lymphoma using rituximab. J Neurooncol. 2002;59:213–6.CrossRefPubMed

Title: Effect of rituximab on primary central nervous system lymphoma: a meta-analysis
Authors: Yue Song
Yibo Wen
Weili Xue
Yanjie Zhang
Mingzhi Zhang
Publication date: 01-11-2017
Publisher: Springer Japan
Published in: International Journal of Hematology / Issue 5/2017
Print ISSN: 0925-5710
Electronic ISSN: 1865-3774
DOI: https://doi.org/10.1007/s12185-017-2316-z

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