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After rituximab monotherapy induction, patients in complete remission as well as those in partial remission with IPI\u2009&lt;\u20093 at diagnosis (low-risk) continued with rituximab monotherapy and thus chemotherapy free. Most others (high-risk) received R-CHOP-21. Thoracic SOT recipients who progressed (very-high-risk) received alternating R-CHOP-21 and modified R-DHAOx. The primary endpoint was event-free survival (EFS) in the low-risk group. The PTLD-1 trials provided historical controls. Rituximab was applied subcutaneously. Of 60 patients enrolled, 21 were low-risk, 28 high-risk and 9 very-high-risk. Overall response was 45\/48 (94%, 95% CI 83\u201398). 2-year Kaplan\u2013Meier estimates of time to progression and overall survival were 78% (95% CI 65\u201390) and 68% (95% CI 55\u201380) \u2013 similar to the PTLD-1 trials. Treatment-related mortality was 4\/59 (7%, 95% CI 2\u201317). In the low-risk group, 2-year EFS was 66% (95% CI 45\u201386) versus 52% in the historical comparator that received CHOP (<jats:italic>p<\/jats:italic>\u2009=\u20090.432). 2-year OS in the low-risk group was 100%. Results with R-CHOP-21 in high-risk patients confirmed previous results. Immunochemotherapy intensification in very-high-risk patients was disappointing.<\/jats:p>","DOI":"10.1038\/s41375-022-01667-1","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T18:02:44Z","timestamp":1660672964000},"page":"2468-2478","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Modified risk-stratified sequential treatment (subcutaneous rituximab with or without chemotherapy) in B-cell Post-transplant lymphoproliferative disorder (PTLD) after Solid organ transplantation (SOT): the prospective multicentre phase II PTLD-2 trial"],"prefix":"10.1038","volume":"36","author":[{"given":"Heiner","family":"Zimmermann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7025-1735","authenticated-orcid":false,"given":"Christian","family":"Koenecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin H.","family":"Dreyling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Pott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4034-9472","authenticated-orcid":false,"given":"Ulrich","family":"D\u00fchrsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Hahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Meidenbauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingeborg A.","family":"Hauser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias J.","family":"Rummel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Wolf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5318-9044","authenticated-orcid":false,"given":"Michael","family":"Heuser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Schlattmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Ritgen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7433-3703","authenticated-orcid":false,"given":"Reiner","family":"Siebert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4003-6855","authenticated-orcid":false,"given":"Ilske","family":"Oschlies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Anagnostopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7565-7160","authenticated-orcid":false,"given":"Ralf U.","family":"Trappe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,16]]},"reference":[{"key":"1667_CR1","doi-asserted-by":"publisher","first-page":"15088","DOI":"10.1038\/nrdp.2015.88","volume":"2","author":"VR Dharnidharka","year":"2016","unstructured":"Dharnidharka VR, Webster AC, Martinez OM, Preiksaitis JK, Leblond V, Choquet S. 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MHD received grant support and personal fees from Roche, all outside the submitted work. UD received grant support from Celgene and personal fees from Amgen and Celltex Patient Treatment, all outside the submitted work. DH received grants from Abbvie, Astellas, Bayer, BerGenBio, BMS, Daiichi Sankyo, Jazz Pharmaceuticals, Novartis, Pfizer and Roche, personal fees from Abbvie, Eurocept, Jannsen, Jazz Pharmaceuticals, Novartis and Takeda, and other non-financial support from Abbvie, Agios, BMS, Daiichi Sankyo, Jazz Pharmaceuticals, Kura Oncology, Pfizer, PinotBio, Roche and Tolremo, all outside the submitted work. IAH received personal fees from Astellas, Biotest, CareDx Inc., MSD, Novartis, Takeda and Teva, all outside the submitted work. CS received personal fees from BMS, Gliead, Janssen and Novartis and non-financial support from BMS, Gliead, Jannsen, Novartis and Roche, all outside the submitted work. PS received grants from the German research foundation and the German Ministry for Education and Research, all outside the submitted work. MR received personal fees from Abbvie, AstraZeneca, Jannsen, MSD and Roche, all outside the submitted work. NM received non-financial support from GlaxoSmithKline, PharmaMar and Jannsen, all outside the submitted work. RS received grant support from the German Cancer Aid, the German Research Foundation, KKI Buchholz\/Holm Seppensen, the BW Foundation and the German Ministry for Education and Research, and personal fees from AstraZeneca, all outside the submitted work. RUT received grant support from Roche during the conduct of the study; grant support from Roche and ATARA, personal fees from Abbvie and ATARA, and other non-financial support from Abbvie, ATARA, Celgene, Janssen and Roche, all outside the submitted work. All other authors declared no conflicts of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}