Long term remission of Sjogren's syndrome associated aggressive B cell non-Hodgkin's lymphomas following combined B cell depletion therapy and CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)

Voulgarelis, Michael; Giannouli, Stavroula; Tzioufas, Athanasios G.; Moutsopoulos, Haralampos Μ.

doi:10.1136/ard.2005.046193

Cited by 74 publications

(31 citation statements)

References 22 publications

(18 reference statements)

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“…Several reports have described the safety and efficacy of B-cell depletion treatment in combination with CHOP for the management of aggressive NHL in SS patients [7,15,16]. Case reports have described the use of monotherapy with rituximab for the treatment of NHL-complicating SS.…”

Section: Discussionmentioning

confidence: 95%

Combined Therapy with Rituximab Plus Cyclophosphamide/Vincristine/Prednisone for Sjogren’s Syndrome-Associated B-Cell Non-Hodgkin’s Lymphoma

Carbone

Perez-Fernandez

Muñoz

et al. 2007

Clinic Rev Allerg Immunol

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Sjogren's syndrome (SS) is characterized by an increased risk of developing non-Hodgkin's lymphoma (NHL). Optimal treatment for NHL-complicating SS is not clearly established. NHL, which expresses the CD20 antigen on tumor cell surfaces, is a disease entity candidate to treatment with anti-CD20 monoclonal antibodies. We report clinical and immunological data of a patient with SS and NHL who was treated with a regimen consisting of cyclophosphamide/vincristine/prednisone (CVP) plus rituximab. A 68-year-old women had a 26-year history of SS and autoimmune thyroiditis. The clinical course of SS was complicated with severe splenomegaly. An increased percentage of CD19+ B cells (up to 30%) was detected in peripheral blood during follow-up. Clonal rearrangement of immunoglobulin heavy chain was detected. Low-grade B marginal zone lymphoma was diagnosed (peripheral blood immunophenotype: CD19+CD20+CD23+sIg+Kappa; bone marrow immunophenotype: 25% lymphocytes; CD19+CD20+CD79A/BCL2+). She received a total of six cycles of CVP plus rituximab (375 mg/m2). Therapy was well tolerated, and B lymphocytes were depleted from the peripheral blood. Splenomegaly normalized. No evidence of neoplastic infiltration was detected in bone marrow after completion of therapy, while certain symptoms of SS (sicca and arthralgia) improved with treatment. CVP plus rituximab proved effective in a patient with SS with NHL.

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Section: Discussionmentioning

confidence: 95%

Combined Therapy with Rituximab Plus Cyclophosphamide/Vincristine/Prednisone for Sjogren’s Syndrome-Associated B-Cell Non-Hodgkin’s Lymphoma

Carbone

Perez-Fernandez

Muñoz

et al. 2007

Clinic Rev Allerg Immunol

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“…R-CHOP regimen has been associated with complete remission (duration 10-23 months) in four patients with SS-aggressive NHL. Importantly, certain signs and symptoms of MC type II (purpura, peripheral neuropathy and arthralgias) significantly improved with treatment, the levels of circulating cryoglobulins and RF decreased, and C4 levels returned to normal (Voulgarelis et al, 2006).…”

Section: Lymphoma Treatmentmentioning

confidence: 97%

Autoimmune Disorders and Lymphomas

Dolcetti¹,

Ponzoni²,

Mappa³

et al. 2011

Autoimmune Disorders - Pathogenetic Aspects

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“…[83,84] B-cell-depleting therapy is also regularly used off-label for pSS patients with severe extraglandular manifestations. In several populations with moderate-to-high systemic disease activity, rituximab has shown a beneficial effect on systemic disease activity and ESSDAI scores.…”

Section: Rituximabmentioning

confidence: 99%

Safety of treatments for primary Sjögren’s syndrome

Nimwegen

Moerman

Smitt

et al. 2016

Expert Opinion on Drug Safety

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Introduction: Primary Sjögren's syndrome (pSS) is a disabling auto-immune disease, affecting exocrine glands and several organs. Areas covered:In this review we analyze the safety of therapies used in pSS. Symptomatic treatment is widely applied due to the good supportive effect and good safety profile. Systemic stimulation of tears and saliva can be successful in pSS. However, cumbersome adverse events can influence the tolerability of this therapy. Evidence for the effectiveness of synthetic DMARDs therapies in pSS is limited, while there is a risk of adverse events. Several studies on biologic DMARD treatment of pSS patients have shown promising efficacy and safety results. Expert opinion: The safety of symptomatic treatment of pSS is very good. However, systemic therapy is necessary to achieve long-term relieve and prevention of organ-damage. Synthetic DMARDs have not shown much efficacy in earlier studies, and their benefits do not weigh up to the possible harms, while biologic DMARDs show promising results regarding efficacy and cause mostly mild adverse events. Many questions remain unanswered regarding safety of DMARDs in pSS. There is a need for well designed studies, in which safety should be evaluated in a uniform manner to be able to compare the results between studies.ARTICLE HISTORY

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Long term remission of Sjogren's syndrome associated aggressive B cell non-Hodgkin's lymphomas following combined B cell depletion therapy and CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)

Cited by 74 publications

References 22 publications

Combined Therapy with Rituximab Plus Cyclophosphamide/Vincristine/Prednisone for Sjogren’s Syndrome-Associated B-Cell Non-Hodgkin’s Lymphoma

Combined Therapy with Rituximab Plus Cyclophosphamide/Vincristine/Prednisone for Sjogren’s Syndrome-Associated B-Cell Non-Hodgkin’s Lymphoma

Autoimmune Disorders and Lymphomas

Safety of treatments for primary Sjögren’s syndrome

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