Second-line immunosuppressive therapy after failure or relapse
| First-line treatment regimen . | Steroids alone (n = 142) . | Steroids + cyclophosphamide (n = 83) . | Rituximab-based (n = 51) . | |||
|---|---|---|---|---|---|---|
| Relapse (n = 15) . | Nonresponse (n = 59) . | Relapse (n = 8) . | Nonresponse (n = 17) . | Relapse (n = 1) . | Nonresponse (n = 20) . | |
| Second-line treatment regimen, n | ||||||
| Steroids + cytotoxics | 1 | 4 | 4 | 2 | 0 | 1 |
| Steroids alone | 5 | 8 | 1 | 0 | 0 | 6 |
| Cytotoxics alone | 0 | 17 | 0 | 0 | 0 | 5 |
| Rituximab alone | 1 | 25 | 0 | 5 | 0 | 1 |
| Steroids + cytotoxics + rituximab | 0 | 1 | 0 | 3 | 0 | 0 |
| Cytotoxics + rituximab | 0 | 0 | 0 | 0 | 0 | 1 |
| Steroids + rituximab | 0 | 1 | 2 | 3 | 0 | 3 |
| No data available | 8 | 3 | 1 | 4 | ND | 3 |
| Second-line treatment outcome | ||||||
| Complete response, n/total evaluable (%) | 7/8 (88) | 28/44 (64) | 5/6 (83) | 8/11 (73) | ND | 7/14 (50) |
| Relapse, n | 2 | 2 | 1 | 1 | ND | 0 |
| Stable complete response, n/total evaluable (%) | 5/8 (63) | 26/44 (59) | 4/6 (67) | 7/11 (64) | ND | 7/14 (50) |
| First-line treatment regimen . | Steroids alone (n = 142) . | Steroids + cyclophosphamide (n = 83) . | Rituximab-based (n = 51) . | |||
|---|---|---|---|---|---|---|
| Relapse (n = 15) . | Nonresponse (n = 59) . | Relapse (n = 8) . | Nonresponse (n = 17) . | Relapse (n = 1) . | Nonresponse (n = 20) . | |
| Second-line treatment regimen, n | ||||||
| Steroids + cytotoxics | 1 | 4 | 4 | 2 | 0 | 1 |
| Steroids alone | 5 | 8 | 1 | 0 | 0 | 6 |
| Cytotoxics alone | 0 | 17 | 0 | 0 | 0 | 5 |
| Rituximab alone | 1 | 25 | 0 | 5 | 0 | 1 |
| Steroids + cytotoxics + rituximab | 0 | 1 | 0 | 3 | 0 | 0 |
| Cytotoxics + rituximab | 0 | 0 | 0 | 0 | 0 | 1 |
| Steroids + rituximab | 0 | 1 | 2 | 3 | 0 | 3 |
| No data available | 8 | 3 | 1 | 4 | ND | 3 |
| Second-line treatment outcome | ||||||
| Complete response, n/total evaluable (%) | 7/8 (88) | 28/44 (64) | 5/6 (83) | 8/11 (73) | ND | 7/14 (50) |
| Relapse, n | 2 | 2 | 1 | 1 | ND | 0 |
| Stable complete response, n/total evaluable (%) | 5/8 (63) | 26/44 (59) | 4/6 (67) | 7/11 (64) | ND | 7/14 (50) |
Second-line immunosuppressive therapy was reported as a proportion of cases and shown dependent on first-line treatment. In patients on whom data are available, 9 of 14 patients (64%) who relapsed had a stable CR, whereas 40 of 69 (58%) of those that did not achieve a first CR did so after second-line therapy.