Rituximab in the Management of Non Hodgkin Lymphoma Expressing CD20
Analysis of patients diagnosed with Non Hodgkin Lymphoma (NHL) who received
MabtheraŽ in our facility in terms of response rate. In the period from June
2001 to June 2004, MabtheraŽ was offered in combination with chemotherapy to
thirty-one patients with confirmed expression of CD20 by immunophenotyping.
Twenty-two patients (71%) were given MabtheraŽ as first line, seven patients
(22.5%) as second line, one patient (3.25%) as third line and one patient
(3.25%) as fourth line treatment. Thirteen patients (42%) were females and
eighteen (58%) were males with a median age of 50.85 years (24-82). Twenty-seven
patients (87%) were diffuse large B cell lymphoma while two (6.5%) were
follicular, one (3.25%) was MALT and one (3.25%) was mantle cell lymphoma.
Chemotherapy regimens used for front line treatment (n=22) were CHOP in thirteen
patients (59%), hyperCVAD in seven patients (32%), one patient (4.5%) received
CNOP and one patient (4.5%) received FND. Second line regimens were all platinum
based. Results: Patients receiving MabtheraŽ as front line therapy, 10/22
(45.4%) had IPI score more than two. Complete remission (CR) was observed in
twelve patients (54.6%) as confirmed by PET scan in six patients (50%), gallium
scan in two patients (20%) and complete radiological and clinical remission in
four patients (30%). Unconfirmed complete remission (CRu) was observed in five
patients (22.7%) and partial remission (PR) in five patients (22.7%). In nine
patients who received MabtheraŽ as salvage, 7/9 (77.78%) had IPI score more than
two and were not offered MabtheraŽ in earlier settings. CR was achieved in two
patients (22.22%) as confirmed by PET scan and PR in seven patients (77.78%). No
nephrotoxicity was observed in patients receiving platinum-based regimens.
Conclusions: The use of MabtheraŽ has yielded an overall response rate of
100% when administrated in combination with chemotherapy in various clinical
settings. There was no nephrotoxicity encountered in combination with
platinum-based regimens.
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