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We analyzed data from the largest integrated healthcare system in the United States, the Veterans Health Administration (VHA), to identify rates of adoption and effectiveness of MR in FL patients after first\u2010line (1L) treatment. We identified previously untreated patients with FL in the VHA between 2006 and 2014 who achieved at least stable disease after chemoimmunotherapy or immunotherapy. Among these patients, those who initiated MR within 238\u00a0days of 1L composed the MR group, whereas those who did not were classified as the non\u2010MR group. We examined the effect of MR on progression\u2010free survival (PFS) and overall survival (OS). A total of 676 patients met our inclusion criteria, of whom 300 received MR. MR was associated with significant PFS (hazard ratio [HR]=0.55, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and OS (HR\u00a0=\u00a00.53, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.005) compared to the non\u2010MR group, after adjusting by age, sex, ethnicity, geographic region, diagnosis period, stage, grade at diagnosis, hemoglobin, lactate dehydrogenase (LDH), Charlson comorbidity index (CCI), 1L treatment regimen, and response to 1L treatment. These results suggest that in FL patients who do not experience disease progression after 1L treatment in real\u2010world settings, MR is associated with a significant improvement in both PFS and OS. Maintenance therapy should be considered in FL patients who successfully complete and respond to 1L therapy.<\/jats:p>","DOI":"10.1002\/cam4.3420","type":"journal-article","created":{"date-parts":[[2020,8,29]],"date-time":"2020-08-29T04:29:23Z","timestamp":1598675363000},"page":"7537-7547","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Maintenance rituximab in Veterans with follicular lymphoma"],"prefix":"10.1002","volume":"9","author":[{"given":"Ahmad S.","family":"Halwani","sequence":"first","affiliation":[{"name":"Division of Hematology and Hematologic Malignancies Huntsman Cancer Institute Salt Lake City Utah USA"},{"name":"Division of Epidemiology VERITAS University of Utah Salt Lake City Utah USA"},{"name":"VERITAS George E Wahlen Department of Veterans Affairs Medical Center Salt Lake City Utah 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