Monthly administration of rituximab is useful for patients with ocular adnexal mucosa-associated lymphoid tissue lymphoma

Mino, Tatsuji; Mihara, Keichiro; Yoshida, Toyonobu; Takihara, Yoshihiro; Ichinohe, Tatsuo

doi:10.1038/bcj.2014.65

Cited by 13 publications

(13 citation statements)

References 15 publications

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“…Rituximab monotherapy therapy was employed more frequently in patients with advanced stage disease and a favourable response was seen in the majority of patients. Our results are consistent with previous reports (Mino et al , ; Tuncer et al , ) although the data on the use of rituximab in that setting is limited.…”

Section: Discussionsupporting

confidence: 93%

Dual institution experience of extranodal marginal zone lymphoma reveals excellent long‐term outcomes

Starr

Caimi

et al. 2016

Br J Haematol

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Extranodal marginal zone lymphoma (EMZL) is a B-cell lymphoma arising from mucosa-associated lymphoid tissue (MALT). The disease characteristics, clinical course and treatment vary considerably based on site of involvement. Because long-term outcome data for EMZL are limited, we sought to describe the clinical details of a large number of patients with EMZL evaluated at the Case Comprehensive Cancer Center over a 12-year period to identify prognostic markers including the impact of site of involvement. We identified 211 cases of EMZL involving the stomach (30%), ocular adnexa (19%), lungs (16%) and intestines (9%). Initial treatment included antibiotics (18%), radiation (21%), rituximab (20%), chemotherapy (3%), rituximab + chemotherapy (7%), surgery (17%) or observation (8%). After a median follow-up of 44·3 months (range 2·2-214·9), median progression-free survival (PFS) was 68·2 months (95% confidence interval [CI] 54·5-111·3) and median overall survival (OS) has not been reached. Age >60 years, elevated lactate dehydrogenase level (LDH), ≥4 lymph node groups involvement, and high follicular lymphoma international prognostic index (FLIPI) were associated with inferior PFS/OS. In summary, patients with EMZL have excellent prognosis with median OS in excess of 10 years. Age, elevated LDH, advanced disease, and high FLIPI score are associated with worse outcomes.

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Section: Discussionsupporting

confidence: 93%

Dual institution experience of extranodal marginal zone lymphoma reveals excellent long‐term outcomes

Starr

Caimi

et al. 2016

Br J Haematol

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“…Rituximab alone exhibited moderate activity in treating POALs, particularly MALT lymphoma, with a CR rate of approximately 30%–50% and a median time to progression of 5 months [ 15 – 18 ]. In addition, some studies reported that prolonged administration of rituximab to 8 cycles or administration of rituximab for maintenance can increase the treatment response rate [ 27 , 28 ]. Rigacci et al reported that when rituximab was combined with chlorambucil, the CR rate increased to 89% in low-grade POALs [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…Rigacci et al reported that when rituximab was combined with chlorambucil, the CR rate increased to 89% in low-grade POALs [ 29 ]. Compared to local radiotherapy for localized POALs, Mino et al and Paik et al also reported that chemotherapy, rituximab alone, or immunochemotherapy is an effective treatment for MALT-POAL [ 28 , 30 ]. We observed a CR rate of 76.9% and a 5-year OS rate of 66.7% in 13 patients with stage I–IV POAL after the administration of an oral alkylating agent with or without rituximab; these rates are consistent with the results of Rigacci et al [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies evaluating the responses to radiotherapy or chemotherapy for POALs were based on the clinical, radiologic, and pathologic criteria according to the international response criteria for malignant lymphoma [ 27 , 28 , 30 , 45 ]. Because POALs are irregularly shaped and the tumors are not centrally located, one ocular lesion (which may involve the eye and both adjacent ocular walls), it is difficult to measure the tumor volume.…”

Section: Methodsmentioning

confidence: 99%

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Chemotherapy alone is an alternative treatment in treating localized primary ocular adnexal lymphomas

Yao

Liao

et al. 2017

Oncotarget

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This study investigated the treatment efficacy and long-term adverse effects of various treatment modalities for primary ocular adnexal lymphomas (POALs). We retrospectively reviewed 107 patients who received first-line chemotherapy, radiotherapy, and other treatment modalities from 1990 to 2015. Nighty-three (87%) patients were diagnosed with mucosa-associated lymphoid tissue (MALT) lymphoma, with the orbit being the most common site (49 patients, 46%). Among 91 patients with stage I–IIE1 disease, 26 underwent chemotherapy, 34 underwent radiotherapy, and 31 received other treatment modalities. For chemotherapy, radiotherapy, and other treatment modalities, the 5-year event-free survival (EFS) rates were 90.0%, 89.7%, and 85.8% and the 5-year overall survival (OS) rates were 100%, 90.4%, and 87.5%, respectively. Moreover, among 80 patients with stage I–IIE1 MALT lymphoma, the complete remission, 5-year EFS and OS rates were not significantly different between patients receiving chemotherapy and those receiving radiotherapy. Among 16 patients with stage IIE2–IVE disease, the 5-year EFS rates for chemotherapy alone (n = 11) and combined radiotherapy and chemotherapy (n = 5) were 61.7% and 80%, respectively, whereas the 5-year OS rate for both groups was 80.0%. Neutropenia (15.2%) was the most common side effect in patients who received chemotherapy, whereas cataract (16.3%) was the most common late sequela in patients who received radiotherapy. Multivariate analysis revealed that old age (> 60 y) and an advanced stage (stage III/IV) were prognostic factors for poor OS. Our results indicate that chemotherapy yields satisfactory disease control and fewer side effects, and acts as an alternative therapy for patients with localized POALs.

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“…Only few case series are available on the efficacy of single agent Rituximab immunotherapy in primary localized MALT OALs as showed in Table 2 [ 7 , 8 , 11 , 12 , 55 – 57 ]. The results of these studies show that systemic immunotherapy could be of primary importance as first-line treatment, because of the high response rates achieved (comparable to those of local radiotherapy), accompanied also by a favorable tolerability profile.…”

Section: Discussionmentioning

confidence: 99%

Rituximab as Single Agent in Primary MALT Lymphoma of the Ocular Adnexa

Annibali

Chiodi

Sarlo

et al. 2015

BioMed Research International

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Ocular Adnexal Lymphomas are the first cause of primary ocular malignancies, and among them the most common are MALT Ocular Adnexal Lymphomas. Recently systemic immunotherapy with anti-CD20 monoclonal antibody has been investigated as first-line treatment; however, the optimal management for MALT Ocular Adnexal Lymphomas is still unknown. The present study evaluated retrospectively the outcome of seven consecutive patients with primary MALT Ocular Adnexal Lymphomas, of whom six were treated with single agent Rituximab. All patients received 6 cycles of Rituximab 375 mg/mq every 3 weeks intravenously. The overall response rate was 100%; four patients (67%) achieved a Complete Remission, and two (33%) achieved a partial response. In four patients an additional Rituximab maintenance every 2-3 months was given for two years. After a median follow-up of 29 months (range 8–34), no recurrences were observed, without of therapy- or disease-related severe adverse events. None of the patients needed additional radiotherapy or other treatments. Rituximab as a single agent is highly effective and tolerable in first-line treatment of primary MALT Ocular adnexal Lymphomas. Furthermore, durable responses are achievable with the same-agent maintenance. Rituximab can be considered the agent of choice in the management of an indolent disease in whom the “quality of life” matter is of primary importance.

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Monthly administration of rituximab is useful for patients with ocular adnexal mucosa-associated lymphoid tissue lymphoma

Cited by 13 publications

References 15 publications

Dual institution experience of extranodal marginal zone lymphoma reveals excellent long‐term outcomes

Dual institution experience of extranodal marginal zone lymphoma reveals excellent long‐term outcomes

Chemotherapy alone is an alternative treatment in treating localized primary ocular adnexal lymphomas

Rituximab as Single Agent in Primary MALT Lymphoma of the Ocular Adnexa

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