Rituximab in primary conjunctiva lymphoma

Zinzani, Pier Luigi; Alinari, Lapo; Stefoni, Vittorio; Loffredo, A; Pichierri, Patrizia; Polito, Ennio

doi:10.1016/j.leukres.2004.05.011

Cited by 33 publications

(15 citation statements)

References 4 publications

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“…by guest www.bloodjournal.org From Eleven patients with ocular adnexal MALT lymphoma received anti-CD20 antibody therapy; 5 had complete and 3 had partial remissions (73%). 30,84,[111][112][113] In light of these preliminary data, the place of rituximab in the treatment of ophthalmologic lymphomas must be more extensively evaluated.…”

Section: Immunotherapy Of Oalmentioning

confidence: 99%

“…11 Although combination chemotherapy with highdose methotrexate is the basis of treatment of primary central nervous system and intraocular lymphomas, 10,12 radiotherapy has been the standard treatment for low-grade ophthalmologic lymphomas. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] However, other treatment options, such as therapy with monoclonal anti-CD20 antibody, 31,32 may constitute a promising alternative to external beam irradiation and its potential toxicity. In addition, some reports have suggested a possible value of anti-Chlamydia psittaci antibiotic therapy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ocular adnexal lymphoma: a review of clinicopathologic features and treatment options

Decaudin

Crémoux

Vincent‐Salomon

et al. 2006

Blood

133

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IntroductionLymphoproliferations of the eye, including intraocular and ocular adnexal non-Hodgkin lymphoma (NHL), constitute a heterogeneous group of neoplasms that represent less than 1% of all NHLs 1 and 5% to 15% of all extranodal sites. 2 First described in 1952, 3 they are the most frequent malignant tumors of the eye and ocular adnexae; in fact, in the Florida cancer registry, they represent up to 55% of all orbital tumors. 4 As for all NHLs, a marked increase of the incidence of ocular adnexal NHL has also been observed. 4 The clinical features and natural history of ocular adnexal lymphoma (OAL) is completely different from those of intraocular lymphoma, which emphasizes the need to distinguish between the therapeutic management of both. Intraocular lymphoma is a subset of primary central nervous system lymphoma, 5-7 and intraocular involvement is found in approximately 15% of affected patients. 8 The histologic subtype of intraocular lymphoma is almost always high grade 9,10 and it can occur in the context ofAIDS-related lymphoproliferations. In contrast, OALs-including lesions of the conjunctiva, lacrimal gland, orbit, and eyelids-are mainly low-grade tumors not associated with HIV infection. 11 Although combination chemotherapy with highdose methotrexate is the basis of treatment of primary central nervous system and intraocular lymphomas, 10,12 radiotherapy has been the standard treatment for low-grade ophthalmologic lymphomas. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] However, other treatment options, such as therapy with monoclonal anti-CD20 antibody, 31,32 may constitute a promising alternative to external beam irradiation and its potential toxicity. In addition, some reports have suggested a possible value of anti-Chlamydia psittaci antibiotic therapy. 33,34 In this review, which is exclusively focused on ophthalmologic lymphomas, we first present the pathologic, clinical, and prognostic factors of these lymphomas and then discuss all available treatment options in terms of safety and efficacy and their respective indications. Biology of ophthalmologic lymphomas Diagnosis of OALAs for all other forms of nodal and extranodal NHL, confirming a positive diagnosis of OAL is often long and difficult because the tumor is very small in most patients. Positive diagnosis must be based on histologic examination of a sufficient tumor sample obtained by surgical biopsy that is large enough to allow rigorous definition of lymphoproliferative disease according to the World Health Organization (WHO) classification. 35 Histopathologic examination consists of morphologic examination of cellular proliferation (cellular appearance and architectural pattern), usually combined with immunohistochemical analysis and molecular analysis.The exact modalities of biopsy depend on the anatomic site of the lesion and its relation to the eye: biopsy may be performed of the conjunctiva, an eyelid lesion, an orbital mass, or the lacrimal gland. However, sometimes patients have nodal involvement, an...

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Section: Immunotherapy Of Oalmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ocular adnexal lymphoma: a review of clinicopathologic features and treatment options

Decaudin

Crémoux

Vincent‐Salomon

et al. 2006

Blood

133

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“…2 So far, only one case of conjunctival follicular lymphoma treated with rituximab alone was reported. 3 However, the evidence for diagnosis was not shown and the follow-up period was only 5 months. 3 Generally, the common side effects of rituximab are not severe, and include fever, chill and nausea.…”

Section: Commentsmentioning

confidence: 98%

“…3 However, the evidence for diagnosis was not shown and the follow-up period was only 5 months. 3 Generally, the common side effects of rituximab are not severe, and include fever, chill and nausea. No side effect of rituximab was observed in this case.…”

Section: Commentsmentioning

confidence: 98%

Primary Conjunctival Follicular Lymphoma Treated with the Anti-CD20 Antibody Rituximab and Low-Dose Involved-Field Radiotherapy

et al. 2007

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LetterPrimary Conjunctival Follicular Lymphoma Treated with the Anti-CD20 Antibody Rituximab and Low-Dose Involved Field Radiotherapy Follicular lymphoma (FL) originating in the ocular adnexa is rarely reported, and curative radiotherapy for it is still questionable. Herein, we report a case of primary FL treated with rituximab, a monoclonal antibody therapy, followed by low-dose involved field radiotherapy (LD-IF-RT). Case ReportA 67-year-old Japanese male patient was referred with a 2-month history of a progressive tumor in the conjunctiva of his right eye (Fig. 1a, b). A tumor sample was obtained by incisional biopsy. By histopathological analysis, it was found to consist of proliferated medium-sized atypical centrocytic lymphoid cells, forming a follicular nodule (Fig. 2a, c). Large centroblastic cells were very few in the nodule (Fig. 2c). The lymphoid cells showed positive immunoreactivity for CD20, CD79α, CD10, bcl-6 (Fig. 2d), and bcl-2 (Fig. 2e) Polymerase chain reaction (PCR) using the tumor DNA detected a fusion product of the major breakpoint region of the bcl-2 gene and IgH J region 1 (Fig. 2f). Based on these findings, the lesion was diagnosed as a follicular lymphoma (FL) grade 1, according to the World Health Organization classification (2001). Consecutive general examinations (including whole-body computed tomography, and Ga-scintigraphy) did not detect any other primary or metastatic lesions. One month after the initial visit, a similar lesion appeared in the conjunctiva of the left eye of the 1 06027 -Takahira patient (Fig. 1c), and also proved to be an FL grade 1 by an additional biopsy (Fig. 2b) and immunohistochemical studies.The patient underwent anti-CD20 antibody therapy (rituximab, 375 mg/m 2 intravenously once weekly for 4 weeks), and the lesions decreased in size gradually. Subsequently, LD-IF-RT with a regimen of 2 days of 2 Gy X-ray (4 Gy total) for both orbital regions was performed.The conjunctival lesions in both eyes diminished approximately one month after the LD-IF-RT (Fig. 1d), and no local recurrence or metastasis was observed during the following 22 months. CommentsPrimary conjunctival FL is very rare. RT-PCR was useful to detect a t(14;18) (q32;q21) translocation 1 from a very small sample of the conjunctival lesion. Until several years ago, the management of FL was basically palliative. Recently, the efficacy of rituximab therapy for follicular lymphoma was evaluated. In a few clinical trials using rituximab alone for untreated follicular lymphomas, response rates ranged between 61% and 80 %. 2 So far, only one case of conjunctival follicular lymphoma treated with rituximab alone was reported. 3 However, the evidence for diagnosis was not shown and the follow-up period was only 5 months. 3 Generally, the common side effects of rituximab are not severe, and include fever, chill and nausea. No side effect of rituximab was observed in this case.Radiotherapy with curative intent for early stage follicular lymphoma is still questionable because of the recurrence rate of approx...

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“…However, one can question the standard dose of 30 Gy used in EBRT; several reports demonstrated the efficacy of low-dose radiotherapy with 2 6 2 Gy, which did not induce significant side effects [3]. Several reports have demonstrated that the anti-CD20 monoclonal antibody rituximab has activity alone in MALT lymphoma [4,5]. However, when it is used as a single agent, the complete remission rate is still low, ranging from 33 to 44% [6,7], which suggests association with chemotherapy optimally but with more toxicities.…”

Section: Hospital Saint Louis Paris Francementioning

confidence: 99%

A revival: radioimmunotherapy in mucosa associated lymphoid tissue lymphoma

Gisselbrecht

2011

Leukemia & Lymphoma

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Rituximab in primary conjunctiva lymphoma

Cited by 33 publications

References 4 publications

Ocular adnexal lymphoma: a review of clinicopathologic features and treatment options

Ocular adnexal lymphoma: a review of clinicopathologic features and treatment options

Primary Conjunctival Follicular Lymphoma Treated with the Anti-CD20 Antibody Rituximab and Low-Dose Involved-Field Radiotherapy

A revival: radioimmunotherapy in mucosa associated lymphoid tissue lymphoma

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