{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T11:49:39Z","timestamp":1769600979958,"version":"3.49.0"},"reference-count":41,"publisher":"Wiley","issue":"16","license":[{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Roche Pharma Spain"},{"DOI":"10.13039\/501100013118","name":"Mundipharma Spain","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100013118","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Consensus is lacking regarding the optimal salvage therapy for patients with follicular lymphoma who relapse after or are refractory to immunochemotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This phase II trial evaluated the efficacy and safety of response\u2010adapted therapy with rituximab, bendamustine, mitoxantrone, and dexamethasone (RBMD) in follicular lymphoma patients who relapsed after or were refractory to first\u2010line immunochemotherapy. Sixty patients received three treatment cycles, and depending on their response received an additional one (complete\/unconfirmed complete response) or three (partial response) cycles. Patients who responded to induction received rituximab maintenance therapy for 2\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010three (55%) and 42 (70%) patients achieved complete\/unconfirmed complete response after three cycles and on completing induction therapy (4\u20106 cycles), respectively (final overall response rate, 88.3%). Median progression\u2010free survival was 56.4\u00a0months (median follow\u2010up, 28.3\u00a0months; 95% CI, 15.6\u201051.2). Overall survival was not reached. Progression\u2010free survival did not differ between patients who received four vs six cycles (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.6665), nor between patients who did\/did not receive rituximab maintenance after first\u2010line therapy (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.5790). Median progression\u2010free survival in the 10 refractory patients was 25.5\u00a0months (95% CI, 0.6\u2010N\/A) and was longer in patients who had shown progression of disease after 24\u00a0months of first\u2010line therapy (median, 56.4\u00a0months; 95% CI, 19.8\u201056.4) than in those who showed early progression (median, 42.31\u00a0months; 95% CI, 24.41\u2013NA) (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.4258). Thirty\u2010six (60%) patients had grade 3\/4 neutropenia. Grade 3\/4 febrile neutropenia and infection were recorded during induction (4\/60 [6.7%] and 5\/60 [8.3%] patients, respectively) and maintenance (2\/43 [4.5%] and 4\/43 [9.1%] patients, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This response\u2010adapted treatment with RBMD followed by rituximab maintenance is an effective and well\u2010tolerated salvage treatment for relapsed\/refractory follicular lymphoma following first\u2010line immunochemotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> # NCT01133158.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.2555","type":"journal-article","created":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T12:38:37Z","timestamp":1569933517000},"page":"6955-6966","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Response\u2010adapted treatment with rituximab, bendamustine, mitoxantrone, and dexamethasone followed by rituximab maintenance in patients with relapsed or refractory follicular lymphoma after first\u2010line immunochemotherapy: Results of the RBMDGELTAMO08 phase II trial"],"prefix":"10.1002","volume":"8","author":[{"given":"Francisco\u2010Javier","family":"Pe\u00f1alver","sequence":"first","affiliation":[{"name":"Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n Alcorc\u00f3n Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9\u2010Antonio","family":"M\u00e1rquez","sequence":"additional","affiliation":[{"name":"Hospital de 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