Rituximab Treatment of Primary Cutaneous Follicle Center Lymphoma: A Retrospective Review

Abstract

Background Primary cutaneous B-cell lymphoma (PCBCL) presents only in the skin at the time of diagnosis with no evidence of extracutaneous disease, and primary cutaneous follicle center lymphoma (PCFCL) is the most common subtype. There is currently a lack of prospective randomized control trials and large retrospective studies investigating the efficacy of different treatment options for PCFCL. This retrospective study was conducted to describe our local clinical experience and outcomes of patients treated with rituximab-containing regimens. Objectives To describe our local clinical experience and treatment outcomes of patients treated with rituximab-containing regimens. Methods A retrospective study consisting of 25 PCFCL patients treated with different modalities. Patient records were reviewed and analyzed using a Kaplan-Meier estimation and SAS 9.4 software. Results After the initial treatment, all patients had CR except for 1 patient in the observation group. Further, 60% of patients in surgery, 20% in chemoimmunotherapy, 67% in rituximab monotherapy, 33% in steroid injection/systemic prednisone, and 33% in observation experienced a relapse. Although no significant difference was found between treatment groups due to the small sample size, time to relapse trends provides insight into treatment responses. Chemoimmunotherapy had the lowest relapse rate in the first 5 years post-treatment, whereas surgery had a higher tendency to relapse. Conclusions Despite the potential for rituximab-containing chemoimmunotherapy to yield adverse effects, it is effective in achieving a prolonged clinical remission in patients with PCFCL. It remains a reasonable treatment option for diffuse, extensive, or treatment-resistant disease.

Cutaneous B‐cell lymphomas: 2023 update on diagnosis, risk‐stratification, and management

“…49 Therefore, complete excision alone, deferring radiation until disease recurrence, is also reasonable. Intralesional [e.g., corticosteroids or rituximab [58][59][60] or topical therapies including corticosteroids, nitrogen mustard and bexarotene may also be considered. 61,62 While radiation therapy is generally recommended for patients with a solitary lesion, radiation therapy or observation (i.e., "watch and wait") are reasonable options for those patients with multiple lesions.…”

Adolescent with primary cutaneous follicle center lymphoma treated with rituximab

“…While initial response rates are good, relapse rates vary from 30% to as high as 67% based on the study, extent of disease, and treatment choice. 3,9,11,13,15 Fortunately, relapses are generally localized, dissemination is rare, and local recurrences do not usually affect overall survival. Relapses may be treated like the initial management of PCFCL, as they are usually localized to the skin.…”