Maintenance Rituximab Following Rituximab Induction for Follicular Lymphoma: A Single-Center Experience

Follicular lymphoma typically affects patients in their fifth, sixth, and seventh decades of life and carries a median survival of 10 years. Rituximab induction followed by maintenance has been increasingly used in follicular lymphoma for patients with low tumor burden progression who wish to receive treatment but want to avoid the side effect profile of chemotherapy. Data on the efficacy of this course is limited for patients previously treated with rituximab as well as those with intermediate risk disease. Here we present data from a single center on the efficacy of induction and maintenance rituximab in a cohort with a mix of intermediate and low risk patients.

26 patients with FL underwent a course of induction rituximab followed by maintenance from 2007 to 2024. 15% were bulky by GELF, 27% were high risk by FLIPI, and 35% had received prior treatment with all but one of the previously treated patients having received rituximab.

Estimated median 2 year PFS was 71%, TTNT was 68%, and OS was 88%. Median follow up time was 1.72 years. Eight patients deepened their response during maintenance to a CR.

In this study, intermediate and low risk FL patients responded well to induction rituximab followed by maintenance with survival comparable to past studies of higher risk patients. This study provides evidence that even those patients previously treated with rituximab can benefit from retreatment rituximab with maintenance.