Maintenance therapy in diffuse large B-cell lymphoma.

PURPOSE OF REVIEW: In this article, we focused on the role of maintenance therapy in diffuse large B-cell lymphoma (DLBCL).

RECENT FINDINGS: Treatment with maintenance rituximab after a response to induction therapy appears to be an effective approach to extending response duration. In randomized phase III trials, investigators have reported improved event-free and progression-free survival with maintenance rituximab in patients with newly diagnosed follicular lymphoma.

SUMMARY: Rituximab administered as induction or maintenance therapy in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) significantly prolonged event-free survival. However, continued use of rituximab after R-CHOP failed to demonstrate benefit. The necessity of a subsequent dose-intense consolidation or maintenance strategy continues to be an issue. High-dose therapy followed by autologous stem cell transplantation is the treatment of choice for patients with relapsed DLBCL who are still responding to salvage therapy. Although rituximab is effective, its role in salvage therapy after autologous transplant remains unclear. Maintenance therapy with rituximab in patients with complete remission after autologous transplant may be a useful novel approach capable of eradicating minimal residual disease. However, there are currently no data confirming this hypothesis.