Granulocyte-macrophage colony stimulating factor-induced immune priming of cyclophosphamide, doxorubicin, vincristine, and prednisone with rituximab chemoimmunotherapy in previously untreated patients with diffuse large B-cell lymphoma and mantle cell lymphoma

Reem Karmali*, Melissa L. Larson, James E. Wooldridge, Stephanie A. Gregory, Teresa O'Brien, Jamile M. Shammo, Katherine Bueschel, Parameswaran Venugopal

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Granulocyte-macrophage colony stimulating factor (GM-CSF) has been shown to enhance CD20 antigen expression, augment antibody-dependent cell-mediated cytotoxicity, and stimulate immune cell proliferation. This may lead to an improved anti-tumor effect of rituximab while reducing the severity of chemotherapy-induced myelosuppression. We evaluated the safety and efficacy of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in sequential combination with GM-CSF priming and rituximab in previously untreated patients (n = 39) with diffuse-large B-cell lymphoma (DLBCL) and mantle cell lymphoma (MCL). CHOP was administered every 21 days on day 1, GM-CSF 250 μg/m 2/day on days 9 through 15, and rituximab 375 mg/m 2 on day 15 of each cycle. The overall response rate was 87%, with complete response in 64%. At a median follow-up of 84.3 months, the overall and progression-free survival rates were 54% and 49%, respectively. The most common toxicity was myelosuppression. Sequential combination of CHOP with GM-CSF priming and rituximab was feasible and effective, warranting further evaluation.

Original languageEnglish (US)
Pages (from-to)2097-2104
Number of pages8
JournalLeukemia and Lymphoma
Volume52
Issue number11
DOIs
StatePublished - Nov 2011

Keywords

  • Chemoimmunotherapy
  • Diffuse large B-cell lymphoma
  • GM-CSF
  • Immune priming
  • Immunomodulation
  • Mantle cell lymphoma

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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