Absolute lymphocyte count predicts response to rituximab-containing salvage treatment for relapsed/refractory B-cell non-Hodgkin's lymphoma with prior rituximab exposure

Background: Rituximab-containing salvage chemotherapy has shown promising efficacy in patients with relapsed/refractory B-cell non-Hodgkin's lymphoma (NHL). The aim of this study was to examine the efficacy of rituximab-containing treatment in patients with B-cell NHL who developed relapsed or refractory disease after prior rituximab use and to explore the predictive factors of response using this approach. Methods: Patients with relapsed/refractory B-cell NHL who received rituximab-containing salvage treatment after failing first-line rituximab-combining chemotherapy were enrolled in this retrospective study. The characteristics of the patients were collected and analyzed. Logistic regression analysis was used for determining predictive factors of response to rituximab-containing salvage treatment. Results: A total of 68 patients were enrolled in this study and the overall response rate to rituximab-containing salvage treatment was 61.7%. The median event-free survival and overall survival with rituximab-containing salvage treatment was 11.3 and 21.73 months, respectively. Results of a multivariate analysis showed high absolute lymphocyte count at the time of rituximab-containing salvage treatment [(ALC-R), ALC-R ≥ 1000/UL, p = 0.003)], which was the only independent factor predicting response to rituximab-containing salvage treatment. Conclusion: Our study results show that for patients with relapsed/refractory B-cell NHL, rituximab-containing salvage treatment is feasible and generally tolerable. A high ALC-R value was significantly associated with a better response to this treatment.