Journal article
Benefit of Rituximab Maintenance After First-line Bendamustine-Rituximab in Patients with Mantle Cell Lymphoma
Blood advances, Vol.10(4), pp.1372-1380
02/24/2026
DOI: 10.1182/bloodadvances.2025018527
PMCID: PMC12927045
PMID: 41380101
Abstract
•Rituximab maintenance was associated with improved EFS and OS after frontline bendamustine and rituximab in patients with MCL.•These results support using rituximab maintenance after frontline bendamustine and rituximab in clinical practice and clinical trials.
The benefit of rituximab maintenance after first-line (1L) bendamustine and rituximab (BR) in patients with mantle cell lymphoma (MCL) remains uncertain, with inconsistent results from the phase 2 MAINTAIN trial and several retrospective studies. We conducted a large retrospective study at 27 US and Canadian academic centers to examine the benefit of rituximab maintenance after BR. A total of 911 patients received 1L BR between 2010-2020, and 703 had an objective response and no evidence of disease progression at the 3-month post-BR landmark. Among those, 394 (56%) received rituximab maintenance and 309 (44%) did not, with largely similar baseline patient and disease characteristics. In the landmark analysis, rituximab maintenance was associated with improved event-free survival (EFS, median 49.9 vs 29.7 months, P < 0.001) as well as overall survival (OS, median 109.5 vs 74.2 months, P < 0.001). The EFS and OS benefits were observed across most of the subgroups. EFS and OS differences were statistically significant in those who achieved a complete response to 1L BR (n=590; median EFS 62.7 vs 31.1 months, P < 0.001; median OS 136.1 vs 75.3 months, P < 0.001), but the analysis in those who achieved a partial response to 1L BR was limited by the small sample size. These results provide additional evidence for the survival benefit of rituximab maintenance after BR in MCL and support its use in clinical trial design and routine practice.
Details
- Title: Subtitle
- Benefit of Rituximab Maintenance After First-line Bendamustine-Rituximab in Patients with Mantle Cell Lymphoma
- Creators
- Yucai Wang - Mayo ClinicMelissa C. Larson - Mayo ClinicSteven R. Hwang - Mayo ClinicDiego Villa - BC Cancer AgencyLaveniya Kugathasan - University of British ColumbiaAnita Kumar - Memorial Sloan Kettering Cancer CenterAshlee Joseph - Memorial Sloan Kettering Cancer CenterTaylor R. Brooks - Cleveland ClinicBrian T. Hill - Cleveland ClinicDavid A. Bond - The Ohio State UniversityKami J. Maddocks - The Ohio State UniversityImran A. Nizamuddin - Washington University in St. LouisBrad S. Kahl - Washington University in St. LouisAlexey Danilov - City Of Hope National Medical CenterChristine Argao - City Of Hope National Medical CenterJia Ruan - Weill Cornell MedicineChristine E. Ryan - Dana-Farber Cancer InstituteReid W. Merryman - Dana-Farber Cancer InstituteNatalie S. Grover - UNC Lineberger Comprehensive Cancer CenterNazneen B. Khan - UNC Lineberger Comprehensive Cancer CenterEvguenia Ouchveridze - University of Kansas Medical CenterAung M. Tun - University of Kansas Medical CenterSabarish Ayyappan - University of IowaEric Mou - University of IowaGeorgios Pongas - Sylvester Comprehensive Cancer CenterIzidore S. Lossos - University of MiamiZoey I. Harris - Mayo ClinicJavier L. Munoz - Mayo Clinic HospitalPhilip Young - University of VirginiaCraig A. Portell - University of VirginiaFiras Baidoun - Mayo Clinic in FloridaMuhamad Alhaj Moustafa - Mayo Clinic in FloridaPatrick M. Reagan - University of Rochester Medical CenterLauren G. Banaszak - University of Wisconsin Carbone Cancer CenterPriyanka A. Pophali - University of Wisconsin Carbone Cancer CenterArash Velayati - UC Davis HealthI. Brian Greenwell - Charleston Hematology Oncology AssociatesDrew Gerber - Columbia University Irving Medical CenterPreetesh Jain - The University of Texas MD Anderson Cancer CenterMichael L. Wang - The University of Texas MD Anderson Cancer CenterMayur S. Narkhede - University of Alabama at BirminghamAmitkumar Mehta - University of AlabamaAnthony C. Stack - Fox Chase Cancer CenterMarcus R. Messmer - Fox Chase Cancer CenterRahul S. Bhansali - Hospital of the University of PennsylvaniaStefan K. Barta - Hospital of the University of PennsylvaniaTamara K. Moyo - Levine Cancer InstituteNilanjan Ghosh - Levine Cancer InstituteManali K. Kamdar - University of Colorado DenverJacob Anna - University of Colorado Anschutz Medical CampusAlexander V. Stanisic - Northwestern UniversityReem Karmali - Northwestern UniversityMatthew J. Maurer - Mayo ClinicJames R. Cerhan - Mayo ClinicJonathon B. Cohen - Emory UniversityPeter Martin - NYU Langone Health
- Resource Type
- Journal article
- Publication Details
- Blood advances, Vol.10(4), pp.1372-1380
- DOI
- 10.1182/bloodadvances.2025018527
- PMID
- 41380101
- PMCID
- PMC12927045
- NLM abbreviation
- Blood Adv
- ISSN
- 2473-9529
- eISSN
- 2473-9537
- Publisher
- Elsevier Inc
- Grant note
- Lymphoma Research Foundation
Y.W. is a recipient of the Clinical Investigator Career Development Award from the Lymphoma Research Foundation.
- Language
- English
- Electronic publication date
- 12/11/2025
- Date published
- 02/24/2026
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Internal Medicine
- Record Identifier
- 9985091813402771
Metrics
3 Record Views