Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0079731 (B-cell lymphoma)
 16,671 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Treatment with the anti-CD20 antibody rituximab prior to stem cell collection may lead to tumor-free stem cell collections in patients with B-cell lymphoma undergoing autologous stem cell transplantation. To test the feasibility of obtaining polymerase chain reaction (PCR)-negative stem cell collection, 30 patients with a variety of B-cell lymphomas were enrolled in a protocol employing a common MINE (mitoxantrone/ifosfamide/etoposide) salvage regimen with rituximab (in vivo purging). Rituximab 400 mg/m2 was administered weekly for 3 weeks on days 1, 6, and 8 in relation to the last MINE cycle, which was followed by growth factor-stimulated peripheral stem cell collection. The median number of CD34(+) cells/kg was 2.5 million cells/kg collected over a median of 5 days. Polymerase chain reaction amplification for the t (14;18) or the heavy-chain gene rearrangement was performed prior to treatment and on the leukapheresis sample. Out of 15 patients who had a positive PCR signal prior to treatment, 10 had PCR-negative stem cell collections, whereas 5 had PCR-positive stem cell collections. After high-dose chemotherapy and stem cell transplant, all patients with a PCR-positive signal pretreatment became PCR negative. We conclude that rituximab may increase the yield of tumor-free stem cells. Higher rates of PCR negativity have been reported when more intense and protracted chemoimmunotherapy regimens have been employed. The magnitude of clinical benefit and the significance of the PCR analysis in stem cells after rituximab requires larger studies.
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PMID:Mitoxantrone/ifosfamide/etoposide salvage regimen with rituximab for in vivo purging in patients with relapsed lymphoma. 1243 84

Rituximab is a chimeric mouse/human anti-CD20 antibody licensed for the treatment of low-grade non-Hodgkin's lymphoma and has recently also been shown to have a role in the treatment of diffuse large B-cell lymphoma. We report a case of Stevens-Johnson syndrome after treatment with rituximab, which occurred in a 36-year-old man with relapsed follicular lymphoma. The patient developed mucositis and fevers after the first two injections, followed by a florid maculopapular rash with severe orogenital ulceration after the third infusion. Over several weeks his symptoms progressed with severe cutaneous, orogenital and conjunctival ulceration, leading to visual problems and malnutrition. No improvement occurred with steroids and immunosuppressant therapy. A review of the literature reveals this to be the first reported case of Stevens-Johnson syndrome associated with rituximab therapy.
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PMID:Stevens-Johnson syndrome after treatment with rituximab. 2152 4

Monoclonal antibodies (mAb) have dramatically advanced our ability to treat non-Hodgkin's lymphoma (NHL), and there has been a virtual explosion of clinical data regarding their use. Rituximab is a humanized anti-CD20 mAb and has significant single agent activity in follicular lymphoma, and to a lesser extent in mantle-cell and diffuse large B-cell lymphoma (DLCL). Rituximab appears to have synergistic activity with cytotoxic chemotherapy and the combination has recently demonstrated improved rates of complete remission (CR) and overall survival in older patients with DLCL. Alemtuzumab (Campath-1H) is a humanized mAb targeting CD52 and has recently been approved in the USA for the treatment of fludarabine-refractory B-cell chronic lymphocytic leukaemia. Impressive activity has also been demonstrated in T-cell prolymphocytic leukaemia and mycosis fungoides. The radioconjugated anti-CD20 mAbs ibritumomab tiuxetan and I131-tositumomab also have impressive clinical activity in low-grade B-cell NHL, and the former has demonstrated superior CR rates to rituximab. Myelosuppression is more significant however, and their place in the treatment algorithm remains to be clearly defined. Other immunotoxins (e.g. BL22) and mAb against alternate targets (e.g. epratuzumab, humanized anti-CD22) are in development.
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PMID:Antibody-based therapy of non-Hodgkin's lymphoma. 1246 99

Monoclonal antibodies (MoAbs) have transformed the treatment of lymphomas. The first reports of studies using MoAbs appeared 8 years ago, and current therapy for lymphoma patients usually includes treatment with MoAbs once or several times during the course of their disease. This review covers the use of MoAbs in combination with chemotherapy for the treatment of patients with lymphoma. Rituximab, an unconjugated anti-CD20 chimeric antibody, is certainly the most widely used MoAb, but the use of other unconjugated or radiolabeled MoAbs is increasing quickly. MoAbs are effective if used alone, but the duration of effectiveness is limited. Therefore, when MoAbs are used in curative treatment, they are combined with chemotherapy. There are randomized studies demonstrating the benefit of adding MoAbs to the treatment regimen of patients with diffuse large B-cell lymphoma, but results of ongoing studies regarding the benefit in other lymphomas have not been reported. Many questions must be answered before the best setting for MoAbs in the treatment of lymphoma patients can be determined.
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PMID:Combination of chemotherapy and monoclonal antibodies for the treatment of lymphoma. 1251 33

Rituximab treatment of B-cell lymphoproliferative disease following transplantation is being evaluated. We describe an Epstein-Barr virus-related B-cell lymphoma that developed in a 55-year-old woman, one year after autologous transplantation for relapsing angioimmunoblastic T-cell lymphoma. Complete remission was achieved after four cycles of rituximab and reduced-dose CHOP. This case is discussed in the context of severe immunodepression. Monoclonal anti-CD20 antibodies might restore a balance between T-cell immunosurveillance and EBV proliferation in B-cells,
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PMID:Successful rituximab treatment of an EBV-related lymphoproliferative disease arising after autologous transplantation for angioimmunoblastic T-cell lymphoma. 1252 56

The outcome of patients with aggressive refractory diffuse large B-cell lymphoma (DLCL) is generally poor. A 43-year-old female with DLCL, who relapsed after first line chemotherapy (CHOP--cyclophosphamide, doxorubicin, vincristine, and prednisone) and progressed despite salvage chemotherapy (EPOCH-etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin), was treated effectively with 8 cycles of Rituximab. She is without evidence of disease with a follow-up of 32 months. We report this case to bring to attention the possibility of sustained durable remission with single agent Rituximab in refractory DLCL.
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PMID:Rituximab provides durable remission in a patient with refractory aggressive diffuse B-cell lymphoma failing salvage chemotherapy. 1253 55

The best treatment of type II mixed cryoglobulinemia (MC) has still to be defined. Antiviral treatment for the frequent underlying infectious trigger hepatitis C virus (HCV) may be ineffective, contraindicated, or not tolerated in a fraction of cases, whereas current immunosuppressive treatments may lead to relevant complications. Selective B-cell blockade with rituximab was used in this study, based on favorable results in preliminary experience. Fifteen consecutive patients with type II MC (HCV-related in 12 of 15) were treated with rituximab, 375 mg/m(2) intravenously weekly for 4 weeks. Only medium- to low-dose steroids were allowed, if already administered at the time of recruitment. All patients had active disease, poorly controlled or difficult to manage with previous treatments, including corticosteroids in all. Efficacy and safety of rituximab therapy were evaluated in the following 6 months. The overall follow-up after rituximab treatment ranged from 9 to 31 months. Rituximab proved effective on skin vasculitis manifestations (ulcers, purpura, or urticaria), subjective symptoms of peripheral neuropathy, low-grade B-cell lymphoma, arthralgias, and fever. Nephritis of recent onset went into remission in one case. Laboratory features, that is, significantly decreased serum rheumatoid factor and cryoglobulins and increased C4, were consistent with the clinical efficacy. Treatment was well tolerated, with no infectious complications. Thrombosis of retinal artery or self-limiting panniculitis occurred in one patient each. Rituximab may represent a safe and effective alternative to standard immunosuppression in type II MC. Controlled studies are needed to better define drug indications and the cost-efficacy profile in the different systemic manifestations.
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PMID:Efficacy and safety of rituximab in type II mixed cryoglobulinemia. 1256 Feb 25

The chimeric anti-CD20 monoclonal antibody rituximab has become part of the standard therapy for patients with non-Hodgkin's lymphoma (NHL). To date, more than 300 000 patients have been treated with rituximab worldwide, including patients with indolent and aggressive NHL, Hodgkin's disease and other B-cell malignancies. Combination of rituximab with cytotoxic agents or cytokines has been explored in a number of different studies. Rituximab is now also approved for patients with diffuse large B-cell lymphoma when combined with standard CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine and prednisone). The monoclonal antibody is generally well tolerated. Most adverse events are infusion-associated, including chills, fever and rigor related to the release of cytokines.
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PMID:An overview of the current clinical use of the anti-CD20 monoclonal antibody rituximab. 1264 96

Rituximab is an anti-CD20 chimeric monoclonal antibody that has shown substantial activity in indolent non-Hodgkin's lymphoma (NHL). Recent data indicate that the clinical benefits achieved in the treatment of indolent NHL are mirrored in aggressive NHL. Diffuse large B-cell lymphoma is the most common form of aggressive NHL and accounts for approximately 40% of all NHL cases. Although rapidly fatal if left untreated, diffuse large B-cell lymphoma is responsive to chemotherapy. CHOP has been the gold standard of care in aggressive NHL for over 20 years and, until recently, efforts to improve efficacy have not resulted in substantial increases in clinical benefit. However, long-term survival is seen in less than 50% of patients, highlighting the need for novel therapeutic strategies. The activity of single-agent rituximab in pilot trials in the aggressive setting and its potential to sensitize tumor cells to the effects of chemotherapy, together with its non-overlapping safety profile, have encouraged investigators to combine rituximab with CHOP. The addition of rituximab to CHOP chemotherapy has achieved impressive survival benefits in elderly patients with untreated diffuse large B-cell lymphoma compared with CHOP alone. Importantly, improved response and survival were achieved with minimal additional toxicity, suggesting that immunochemotherapy provides a new standard of care in aggressive NHL. This article reviews the activity of rituximab in aggressive lymphoma and highlights its potential in both previously untreated and relapsed disease.
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PMID:Immunochemotherapy: the new standard in aggressive non-Hodgkin's lymphoma in the elderly. 1265 61

The standard therapy for patients with aggressive lymphoma is cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy, which achieves a complete response in more than 60% of patients but is curative in only about 40-50%. More aggressive and/or dose-intensified chemotherapy regimens have failed to provide significant survival advantages compared with CHOP, and may have higher toxicity. Rituximab, a chimeric monoclonal antibody to the CD20 antigen, is effective as monotherapy in aggressive lymphoma and in combination with chemotherapy has demonstrated high response rates in phase II trials. A scheduled interim analysis of a randomized, prospective trial comparing rituximab plus CHOP with CHOP alone in elderly patients with untreated diffuse large B-cell lymphoma has shown significantly better response rates and survival with rituximab plus CHOP compared with CHOP alone. These results represent the first significant improvement in overall survival over CHOP in aggressive lymphoma for over 20 years. The addition of rituximab was not associated with significant additional toxicity over that seen with CHOP alone. Ongoing studies are underway to establish whether the survival benefit of rituximab plus CHOP is seen in younger patient populations. Rituximab in combination with chemotherapy is also being evaluated as salvage treatment for patients who relapse after initial chemotherapy. In a preliminary analysis of a study in 50 patients with refractory or relapsed aggressive lymphoma, rituximab plus etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (EPOCH) chemotherapy has demonstrated promising results when used as sole salvage therapy and as an induction therapy prior to autologous stem-cell transplantation, again without significant additional toxicity.
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PMID:Aggressive lymphoma: improving treatment outcome with rituximab. 1271 May 90


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