{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:18:23Z","timestamp":1761895103357,"version":"build-2065373602"},"reference-count":43,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2010,6,14]],"date-time":"2010-06-14T00:00:00Z","timestamp":1276473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2010,9,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>This phase 2 trial was undertaken to evaluate the efficacy and safety of rituximab combined with intravenous fludarabine and mitoxantrone (R\u2010FM) for patients with recurrent\/refractory follicular lymphoma who had high tumor burden according to Groupe d'Etude des Lymphomes Folliculaires (GELF) criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>Fifty patients were enrolled who had received a maximum of 2 previous regimens, including 1 cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)\/CHOP\u2010like regimen but no previous exposure to rituximab, fludarabine, or mitoxantrone. At baseline, 58% of patients had bulky disease (lesion &gt;7cm), 56% had high\u2010risk Follicular Lymphoma International Prognostic Index (FLIPI) scores (range, 3\u20105), and 22% were refractory. Treatment consisted of 4 courses of R\u2010FM (rituximab 375 mg\/m<jats:sup>2<\/jats:sup> intravenously on Day 1, fludarabine 25 mg\/m<jats:sup>2<\/jats:sup> intravenously on Days 2 through 4, and mitoxantrone 10 mg\/m<jats:sup>2<\/jats:sup> intravenously on Day 2, recycling at Day 28) and consolidation with 2 courses of fludarabine and mitoxantrone (the same regimen without rituximab).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>The best response (84% overall response rate including 68% complete response\/complete response unconfirmed) was achieved after 4 courses of R\u2010FM. Response rates were high regardless of age, refractoriness to last previous therapy, and FLIPI score. After a median follow\u2010up of 4 years, the 3\u2010year progression\u2010free survival rate was 47%, the event\u2010free survival rate was 41%, and the 3\u2010year overall survival rate was 66%. Grade \u22653 neutropenia and infections were the most common toxicities and occurred in 72% and 14% of patients, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Cytoreduction with 4 courses of R\u2010FM was safe and highly efficient in patients with recurrent\/refractory follicular lymphoma who had high tumor burden; however, better consolidation than FM is needed to further improve outcome. Cancer 2010. \u00a9 2010 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.25280","type":"journal-article","created":{"date-parts":[[2010,6,14]],"date-time":"2010-06-14T16:54:49Z","timestamp":1276534489000},"page":"4299-4308","source":"Crossref","is-referenced-by-count":15,"title":["Efficacy and safety of the combination of rituximab, fludarabine, and mitoxantrone for rituximab\u2010naive, recurrent\/refractory follicular non\u2010Hodgkin lymphoma with high tumor burden"],"prefix":"10.1002","volume":"116","author":[{"given":"Franck","family":"Morschhauser","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Mounier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Sebban","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pauline","family":"Brice","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillippe","family":"Solal\u2010Celigny","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herve","family":"Tilly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Feugier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christophe","family":"Ferm\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie Christine","family":"Copin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thierry","family":"Lamy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,6,14]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-08-3175"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.07.019"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.06.4618"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-04-153189"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V94.8.2836.420k35_2836_2843"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.1995.tb00269.x"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1996.14.4.1262"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.3109\/10428190109057930"},{"key":"e_1_2_7_10_2","first-page":"490","article-title":"The role of mitoxantrone in non\u2010Hodgkin's lymphoma","volume":"16","author":"Armitage JO","year":"2002","journal-title":"Oncology (Williston Park)."},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.10-2-150"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20483"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21882"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.11671"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-07-1371"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/10428190310001623874"},{"key":"e_1_2_7_17_2","first-page":"103a","article-title":"Combined immuno\u2010chemotherapy (R\u2010FCM) results in superior remission and survival rates in recurrent follicular and mantle cell lymphoma. 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