Treatment of Patients With Low-Grade B-Cell Lymphoma With the Combination of Chimeric Anti-CD20 Monoclonal Antibody and CHOP Chemotherapy

Abstract

This is the first report demonstrating the safety and efficacy of Rituxan anti-CD20 chimeric antibody in combination with standard-dose systemic chemotherapy in the treatment of indolent B-cell lymphoma. The clinical responses suggest an additive therapeutic benefit for the combination with no significant added toxicity. The conversion of bcl-2 from positive to negative by PCR in blood and/or marrow suggests possible clearing of minimal residual disease not previously demonstrated by CHOP chemotherapy alone.

Rituximab Infusion Promotes Rapid Complement Depletion and Acute CD20 Loss in Chronic Lymphocytic Leukemia

“…T he anti-CD20 mAb rituximab (RTX) 4 was the first mAb approved for single agent therapy for non-Hodgkin's lymphoma (NHL) (1)(2)(3)(4)(5)(6). The efficacy of this mAb in indolent or follicular NHL is well documented, and it is also being examined as an immunotherapeutic agent against chronic lymphocytic leukemia (CLL) (7)(8)(9)(10).…”

Rituximab in vivo purging is safe and effective in combination with CD34-positive selected autologous stem cell transplantation for salvage therapy in B-NHL

“…7 The clinical development of the chimeric anti-CD20 monoclonal antibody Rituximab has added a new and effective agent for killing lymphoma B cells, and leads to rapid and sustained depletion of peripheral blood B cells. 8,9 Czuzman et al 10 first described a combination of Rituximab and chemotherapy to be feasible, resulting in high remission rates. This sparked a rapidly expanding number of trials using the antibody at different steps in lymphoma treatment.…”

Monoclonal antibodies as therapeutic agents in oncology and antibody gene therapy

“…The ORR was 57% (CR 14%, PR 43%), with a projected median duration of response of 13.4 months. Based on in vitro data suggesting synergistic actions of rituximab and cytotoxic agents including anthracyclines [18], the combination of six cycles of chemotherapy consisting of CHOP (cyclophosphamide, adriamycin, oncovin and prednisone) with concurrently administered rituximab in 40 patients with predominantly untreated follicular lymphoma greatly increased the response rate (55% CR, 40% PR), suggesting synergistic actions with no significant additional toxicity [19]. Median time to disease progression was recently determined to be 82.3 months [20].…”