{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T10:24:07Z","timestamp":1758709447559,"version":"3.40.5"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["19DZ1910300","21Y11909000"],"award-info":[{"award-number":["19DZ1910300","21Y11909000"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The treatment of high\u2010risk B\u2010cell lymphoma (BCL) remains a challenge, especially in the elderly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 83 patients (median age 65\u2009years), who have achieved a complete response after induction therapy, were divided into two groups: R<jats:sup>2<\/jats:sup>\u2009+\u2009GM\u2010CSF regimen (lenalidomide, rituximab, granulocyte\u2010macrophage colony\u2010stimulating factor [GM\u2010CSF]) as maintenance therapy (<jats:italic>n<\/jats:italic>\u2009=\u200939) and observation (<jats:italic>n<\/jats:italic>\u2009=\u200944). The efficacy of the R<jats:sup>2<\/jats:sup>\u2009+\u2009GM\u2010CSF regimen as maintenance in patient with high\u2010risk BCL was analyzed and compared with observation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The number of natural killer cells in patients increased after R<jats:sup>2<\/jats:sup>\u2009+\u2009GM\u2010CSF regimen administration (0.131\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L vs. 0.061\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L, <jats:italic>p<\/jats:italic>\u2009=\u20090.0244). Patients receiving the R<jats:sup>2<\/jats:sup>\u2009+\u2009GM\u2010CSF regimen as maintenance therapy had longer remission (duration of response: 18.9 vs. 11.3\u2009months, <jats:italic>p<\/jats:italic>\u2009=\u20090.001), and longer progression\u2010free survival (not reached (NR) vs. 31.7\u2009months, <jats:italic>p<\/jats:italic>\u2009=\u20090.037), and overall survival (OS) (NR vs. NR, <jats:italic>p<\/jats:italic>\u2009=\u20090.015). The R<jats:sup>2<\/jats:sup>\u2009+\u2009GM\u2010CSF regimen was safe and well tolerated. High international prognostic index score (<jats:italic>p<\/jats:italic>\u2009=\u20090.012), and high tumor burden (<jats:italic>p<\/jats:italic>\u2009=\u20090.005) appeared to be independent prognostic factors for worse PFS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The maintenance therapy of R<jats:sup>2<\/jats:sup>\u2009+\u2009GM\u2010CSF regimen may improve survival in high\u2010risk BCL patients, which might be modulated by amplification of natural killer cells. The efficacy of the R<jats:sup>2<\/jats:sup>\u2009+\u2009GM\u2010CSF maintenance regimen has to be further validated in prospective random clinical trials.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.5969","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T05:15:58Z","timestamp":1682054158000},"page":"12975-12985","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Maintenance regimen of <scp>GM\u2010CSF<\/scp> with rituximab and lenalidomide improves survival in high\u2010risk B\u2010cell lymphoma by modulating natural killer cells"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7636-2639","authenticated-orcid":false,"given":"Shunrong","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Hematology Huadong Hospital Affiliated with Fudan University  Shanghai 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