The purpose of this study was to investigate the toxicity and the efficacy of re-treatment with rituximab, a chimeric mouse human anti-CD20 monoclonal antibody, in relapsed patients with indolent B-cell non-Hodgkin’s lymphoma (NHL) who responded to rituximab in the previous phase I or phase II study. Thirteen patients with relapsed B-cell NHL, each of whom was confirmed to have Revised European-American Lymphoma Classification type II, 1–6 histology (indolent B-NHL), enrolled in this re-treatment study. All were re-treated with rituximab at 375 mg/m2 weekly for 4 consecutive weeks. Rituximab re-treatment was well tolerated with no grade 3/4 nonhematological toxicities, similar to that of the initial treatment. No patients developed detectable human anti-chimeric antibody. Partial responses were observed in 5 of 13 patients (38%; 95% confidence interval [CI], 14% to 68%); 6 patients showed stable disease and 2 showed progressive disease. Overall survival rate was 93% at 19 months of median follow-up after rituximab re-treatment. Median progression-free survival (PFS) after the re-treatment was 5.1 months (95% CI, 4.1 to 5.6 months), and the median PFS after the initial treatment was 8.2 months (95%CI, 5.9 to 11.3 months). Although rituximab re-treatment induced prolonged depletion of normal peripheral blood B cells in all patients, no significant decrease in serum immunoglobulin or complement level was observed. In conclusion, rituximab re-treatment was well tolerated, and it may produce a prolonged PFS in some patients with indolent B-cell NHL who showed initial response to rituximab.
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Reff ME, Carner K, Chambers KS, et al. Depletion of B-cells in vivo by a chimeric mouse human monoclonal antibody to CD20.Blood. 1994;83:435–445.
Maloney DG, Liles TM, Czerwinski DK, et al. Phase I clinical trial using escalating single-dose infusion of chimeric anti-CD20 monoclonal antibody (IDEC-C2B8) in patients with recurrent B-cell lymphoma.Blood. 1994;84:2457–2466.
Maloney DG, Grillo-Lopez AJ, White CA, et al. IDEC-C2B8 (rituximab) anti-CD20 monoclonal antibody therapy in patients with relapsed low-grade non-Hodgkin’s lymphoma.Blood. 1997;90:2188–2195.
McLaughlin P, Grillo-Lopez AJ, Link BK, et al. Rituximab chimeric anti-CD20 monoclonal antibody therapy for relapsed indolent lymphoma: half of patients respond to a four-dose treatment program.J Clin Oncol. 1998;16:2825–2833.
Tobinai K, Kobayashi Y, Narabayashi M, et al. Feasibility and pharmacokinetic study of a chimeric anti-CD20 monoclonal antibody (IDEC-C2B8, rituximab) in relapsed B-cell lymphoma.Ann Oncol. 1998;9:527–534.
Coiffier B, Haioun C, Ketterer N, et al. Rituximab (anti-CD20 monoclonal antibody) for the treatment of patients with relapsing or refractory aggressive lymphoma: a multicenter phase II study.Blood. 1998;92:1927–1932.
Davis TA, White CA, Grillo-Lopez AJ, et al. Single-agent monoclonal antibody efficacy in bulky non-Hodgkin’s lymphoma: results of a phase II trial of rituximab.J Clin Oncol. 1999;17:1851–1857.
Tobinai K, Kobayashi Y, Ohtsu T, et al. Phase II study of a chimeric anti-CD20 monoclonal antibody (IDEC-C2B8, rituximab) in relapsed indolent B-cell lymphoma [abstract].Ann Oncol. 1999;10(suppl 3):133.
Harris NL, Jaffe ES, Stein H, et al. A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group.Blood. 1994;84:1361–1392.
Oken MM, Creech RH, Tormey DC, Horton J. Toxicity and response criteria of Eastern Cooperative Oncology Group.Am J Clin Oncol. 1982:5;649–655.
Tobinai K, Kohno A, Shimada Y, et al. Toxicity grading criteria of the Japan Clinical Oncology Group.Jpn J Clin Oncol. 1993;23:250–257.
Grillo-Lopez AJ, Cheson BD, Horning SJ, et al. Response criteria for NHL: importance of “normal” lymph node size and correlations with response rate.Ann Oncol. 2000;11:399–408.
Kaplan EL, Meier P. Nonparametric estimation from incomplete observations.J Am Stat Assoc. 1958;53:457–481.
Mantel L. Evaluation of survival data and two new rank order statistics arising in its consideration.Cancer Chemother Rep. 1966;50:163–170.
The International Non-Hodgkin’s Lymphoma Prognostic Factors Project: a predictive model for aggressive non-Hodgkin’s lymphoma.N Engl J Med. 1993;329:987–994.
Lopez-Guillermo A, Montserrat E, Boche F, et al. Applicability of the international index for aggressive lymphomas to patients with low-grade lymphoma.J Clin Oncol. 1994;12:1343–1348.
Hermans J, Krol ADG, van Groningen K, et al. International prognostic index for aggressive non-Hodgkin’s lymphoma is valid for all malignancy grades.Blood. 1995;86:1460–1463.
Davis T, Levy R, White CA, et al. Rituximab: phase II retreatment study in patients with low-grade or follicular NHL [abstract].Blood. 1998;15(suppl 1):414a.
McLaughlin P, Grillo-Lopez AJ, White C, et al. Prognostic factors for non-Hodgkin’s lymphoma patients treated may not predict response duration in patients treated with immunotherapy: rituximab experience [abstract].Proc Am Assoc Cancer Res. 1999;40:718.
Schmitz K, Brugger W, Weiss B, Kaiserling E, Kanz L. Clonal selection of CD20-negative non-Hodgkin’s lymphoma cells after treatment with anti-CD20 antibody rituximab [letter].Br J Haematol. 1999;106:571–572.
Davis TA, Czerwinski DK, Levy R. Therapy of B-cell lymphoma with anti-CD20 antibodies can result in the loss of CD20 antigen expression.Clin Cancer Res. 1999;5:611–615.
Micallef IN, Kirk A, Norton A, Foran JM, Rohatiner AZ, Lister TA. Peripheral T-cell lymphoma following rituximab therapy for B-cell lymphoma [letter].Blood. 1999;93:2427–2428.
Kinoshita T, Nagai H, Murate T, Saito H. CD20-negative relapse in B-cell lymphoma after treatment with rituximab [letter].J Clin Oncol. 1998;16:3916.
Foran JM, Rohatiner AZS, Cunningham D, et al. European phase II study of rituximab (chimeric anti-CD20 monoclonal antibody) for patients with newly diagnosed mantle-cell lymphoma and previously treated mantle-cell lymphoma, immunocytoma, and small B-cell lymphocytic lymphoma.J Clin Oncol. 2000;18:317–324.
Foran JM, Cunningham D, Coiffier B, et al. Treatment of mantle-cell lymphoma with rituximab (chimeric anti-CD20 monoclonal antibody): analysis of factors associated with response.Ann Oncol. 2000;11(suppl 1):117–121.
Ogura M, Igarashi T, Morishima Y, et al. Factors affecting toxicity, response and time to progression in relapsed patients with indolent B-NHL and mantle cell lymphoma treated with rituximab [abstract].Proc Am Soc Clin Oncol. 2000;19:25.
Piro LD, White CA, Grillo-Lopez AJ, et al. Extended rituximab (anti-CD20 monoclonal antibody) therapy for relapsed or refractory low-grade or follicular non-Hodgkin’s lymphoma.Ann Oncol. 1999;10:655–661.
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Igarashi, T., Ohtsu, T., Fujii, H. et al. Re-Treatment of Relapsed Indolent B-Cell Lymphoma With Rituximab. Int J Hematol 73, 213–221 (2001). https://doi.org/10.1007/BF02981940
- Monoclonal antibody
- Indolent B-cell lymphoma