Granulocyte-Macrophage Colony-Stimulating Factor Potentiates Rituximab in Patients With Relapsed Follicular Lymphoma: Results of a Phase II Study

• DOI: 10.1200/jco.2007.13.7729
• Publication Date: 2008-04-22T00:46:39Z
• Authors: Guillaume Cartron; Lu Zhao-Yang; Marion Baudard; Tarik Kanouni; Valérie Rouillé; Philippe Quittet; Bernard Klein; Jean-Francois Rossi
• Keywords: Follicular lymphoma; Colony-stimulating factor

Purpose We hypothesized that granulocyte-macrophage colony-stimulating factor (GM-CSF) could potentiate the clinical activity of rituximab given its individual and cooperative effects on FcγRIIa- FcγRIIIa-expressing cells. A phase II study combining GM-CSF was initiated in patients with relapsed follicular lymphoma (FL) to determine biologic responses, as well safety combination. Patients Methods Thirty three FL were treated 5 μg/kg/d days 1 8 375 mg/m 2 day each 21-day cycle for four cycles. Clinical response tolerability examined according international criteria. Biologic monitoring included evaluation immune cells involved activity. Results Of 33 evaluated patients, a 70% overall rate (complete plus complete unconfirmed, 45%) median progression-free survival (PFS) 16.5 months achieved. Outcome influenced by quality Follicular Lymphoma International Prognostic Index (FLIPI), where low- intermediate-risk FLIPI groups associated significantly better PFS. After treatment there significant increase granulocyte monocyte counts. Examination dendritic cell showed an plasmacytoid cells, especially non-complete after treatment. Addition did not impair tolerance rituximab, adverse events rare mild. Discussion results high rates, along tolerable profile or progressive FL. The improved efficacy over monotherapy may be due increases seen monocyte, granulocyte, populations.