Researchers from Austria have reported that the combination of thalidomide and rituximab is effective for the treatment of relapsed/refractory mantle cell lymphoma with a low toxicity profile. The details of this study appeared in the October 15, 2004 issue of Blood .

Mantle cell lymphoma is a disease that historically has responded poorly to combination chemotherapy. However, over the past decade, there has been marked improvement in treatment strategies for patients with mantle cell lymphoma, including rituximab and other monoclonal antibody-based therapies. Good results have also been reported with autologous and non-marrow ablative allogeneic transplants.

In this recent study, researchers evaluated the combination of thalidomide and rituximab. The rationale for evaluating thalidomide is the marked activity of this drug in treating multiple myeloma. Thalidomide was administered at the relatively low dose of 200 mg per day along with rituximab once weekly to 16 patients with refractory or relapsed mantle cell lymphoma. The complete response rate was 31%, with an overall response rate of 81%. They reported a median progression-free survival of 20.4 months with a 3-year survival of 75%. The most common side effect of thalidomide therapy is thromboembolism and this complication occurred in two patients.

Comments: This study suggests that the addition of thalidomide to rituximab may improve overall response rate. However, it would take a randomized trial to determine if the combination is really better than either drug alone.

Reference: Kaufmann H, Raderer M, Wohrer, et al. Antitumor activity of rituximab plus thalidomide in patients with relapsed/refractory mantle cell lymphoma. Blood. 2004;104:2269-2271.