Successful Treatment of Refractory Low Grade Duodenal Lymphoma With Rituximab, an Anti-cd20 Monoclonal Antibody

Ahmed, Shazia; Singh, Aman; Krauss, John C.; Wentz, Tracey; Gunaratnam, Naresh T.

doi:10.1097/01.coc.0000026485.57632.1e

Cited by 8 publications

(7 citation statements)

References 9 publications

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“…22,23 . Small bowel lymphomas are rare for several reasons, 24 however, the incidence of this disease has been rising in recent years, particularly among immunocompromised patients. 25 -27 Primary follicular lymphoma of the small intestine is a distinct entity that originates from local antigen-responsive B cells, whereas little is known about the pathogenesis of primary small bowel lymphoma.…”

Section: Discussionmentioning

confidence: 99%

Primary Small-bowel Non-Hodgkin's Lymphoma: A Study of Clinical Features, Pathology, Management and Prognosis

et al. 2007

J Int Med Res

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The records of 34 patients diagnosed with primary small bowel non-Hodgkin's lymphoma during a 10-year period between January 1996 and December 2005, including 27 cases for which complete follow-up records were available, were studied. Abdominal pain (70.6% of patients) was the main presenting symptom, followed by intestinal obstruction (38.2%). The most common primary site was the ileum (58.8%), followed by the jejunum (26.5%) and duodenum (17.6%); one case had tumours at two sites in the small bowel. Twenty-seven patients had small bowel B-cell lymphoma (24 diffuse large B-cell lymphoma; three mucosa-associated lymphoid tissue B-cell lymphoma) and seven patients had small bowel T-cell lymphoma. Cumulative survival in patients with small bowel B-cell lymphoma was higher than that in patients with small bowel T-cell lymphoma. Data on 16 male and eight female patients with diffuse large B-cell lymphoma showed that 62.5% of these patients presented with disease stages I or II and 37.5% with stages III or IV. Cumulative survival in patients at stages IE or IIE was significantly higher than that of patients at stages IIIE or IVE. Four of five patients who died from diffuse large B-cell lymphoma had abnormal levels of lactate dehydrogenase and serum albumin.

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Section: Discussionmentioning

confidence: 99%

Primary Small-bowel Non-Hodgkin's Lymphoma: A Study of Clinical Features, Pathology, Management and Prognosis

et al. 2007

J Int Med Res

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“…Intestinal obstructions usually occurred in patients with small-intestinal lesions, whereas bleeding was observed mostly in patients with colorectal lesions ( Table 2). In some cases, patients with GI-FL have a protein-losing enteropathy [16,22,[40][41][42][43].…”

Section: Clinical Symptomsmentioning

confidence: 99%

Gastrointestinal follicular lymphoma: review of the literature

et al. 2010

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Gastrointestinal follicular lymphoma (GI-FL) is a relatively rare disease, accounting for only 1%-3.6% of gastrointestinal non-Hodgkin's lymphoma. Although the duodenum and terminal ileum are considered to be the most common sites of origin, the development of wireless capsule endoscopy and double-balloon enteroscopy has increased the detection of GI-FL in every part of the small intestine. Approximately 70% of patients with GI-FL are estimated to have multiple lesions throughout the entire gastrointestinal tract. FL is a low-grade lymphoma that usually develops very slowly. If the lymphoma causes no symptoms, immediate treatment may not be necessary. Standard therapy has not yet been established for GI-FL, but chemotherapy, radiotherapy, monoclonal antibody therapy, or a combination of these therapies, is sometimes performed based on the therapeutic regimens for nodal FL. Regimens including conventional chemotherapy with rituximab, which achieve high response rates in nodal FL, are commonly used for GI-FL. The long-term clinical outcome of GI-FL is unclear. The results of a few series on the long-term outcomes of patients with GI-FL treated with conventional therapy indicate a median relapse-free time ranging from 31 to 45 months. On the other hand, in patients with GI-FL who were followed without treatment, the median time to disease progression was 37.5 months. Thus, whether to initiate aggressive therapy or whether to continue watchful waiting in patients with GI-FL is a critically important decision. Ongoing research on biomarkers to guide individualized GI-FL therapy may provide invaluable information that will lead to the establishment of a standard therapeutic regimen.

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“…Randomised trials have shown its benefit in terms of response rates and prolonged survival with respect to nonrituximab-containing regimens in FL as well as in diffuse large cell lymphoma [14,15]. Anecdotal cases of rituximab plus chemotherapy, and rituximab in chemotherapy-resistant duodenal FL have been reported, showing that rituximab can be an effective treatment in this situation [10,16]. To our knowledge, our report is the first in which rituximab is given as initial therapy for a duodenal FL, confirming the activity of this drug in this infrequent condition, and showing that rituximab can be an attractive and effective non-toxic option for patients with localised duodenal FL not suitable for more aggressive approaches such as surgery or chemotherapy.…”

Section: Discussionmentioning

confidence: 95%

“…Pathology reveals FL grade 1 according to the WHO classification [7] as the most common type, with immunophenotypes that are similar to its nodal counterpart (CD 20, CD10, Bcl-2 positive in most of cases) [8]. Although heterogeneous, a typical endoscopic pattern consists of small nodules or granules, usually whitish, and sometimes with a polypoid aspect [4][5][6][9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Primary duodenal follicular lymphoma successfully treated with rituximab

et al. 2007

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Non-Hodgkin's lymphoma (NHL) of the gastrointestinal (GI) tract is the most common extranodal lymphoma, accounting for approximately 40% of all extranodal NHLs. Initial treatment of duodenal lymphoma includes surgery, chemotherapy and radiotherapy, alone or in combination. Here, we present a case of stage I primary duodenal follicular lymphoma (FL) showing a complete response after rituximab therapy. Rituximab alone can be an effective alternative treatment for duodenal FL.

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Successful Treatment of Refractory Low Grade Duodenal Lymphoma With Rituximab, an Anti-cd20 Monoclonal Antibody

Cited by 8 publications

References 9 publications

Primary Small-bowel Non-Hodgkin's Lymphoma: A Study of Clinical Features, Pathology, Management and Prognosis

Primary Small-bowel Non-Hodgkin's Lymphoma: A Study of Clinical Features, Pathology, Management and Prognosis

Gastrointestinal follicular lymphoma: review of the literature

Primary duodenal follicular lymphoma successfully treated with rituximab

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