Rituximab monotherapy for primary cutaneous B-cell lymphoma: response and follow-up in 16 patients

Valencak, Julia; Weihsengruber, Felix; Rappersberger, Klemens; Trautinger, Franz; Chott, Andreas; Streubel, Berthold; Muellauer, Leonhard; Der-Petrossian, Manon; Jonak, Constanze; Binder, Michael; Raderer, Markus

doi:10.1093/annonc/mdn636

Cited by 63 publications

(47 citation statements)

References 19 publications

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“…Pertinently, no infectious complication has been reported for patients in whom rituximab was initiated alone, without systemic corticosteroids or other immunosuppressants. 47,48 Conventional systemic treatment failure duetosevereadverseeventsissometimesobservedinpatients with MMP. 6,[12][13][14] To our knowledge, no study comparing the infectious risk of conventional immunosuppressants vs rituximab is available.…”

Section: Commentmentioning

confidence: 99%

Rituximab for Patients With Refractory Mucous Membrane Pemphigoid

Roux–Villet¹,

Prost-Squarcioni²,

Alexandre³

et al. 2011

Arch Dermatol

129

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Background: Mucous membrane pemphigoid (MMP) still represents a potentially life-and sight-threatening disease. In a subset of patients with severe MMP, conventional immunosuppressants are ineffective or contraindicated.Observations: Twenty-five patients with severe refractory MMP, including 5 with mucous membranedominant epidermolysis bullosa acquisita, received 1 or 2 cycles of rituximab (375 mg/m 2 weekly for 4 weeks). Twenty-one of the patients were receiving concomitant therapy with dapsone and/or sulfasalazine therapy, which was maintained during rituximab cycles. Complete responses in all affected sites (ocular and/or extraocular) were obtained in 17 patients (68%) by a median time of 12 weeks after the first cycle, and 5 additional patients responded completely after a second cycle, yielding an 88% complete response rate. In all but 1 of the 10 patients with ocular lesions, their eyes became noninflammatory within a mean of 10 weeks. Among the 3 patients (12%) who developed severe infectious complications, 2 (8%) died; they had been receiving concomitant conventional immunosuppressants and high-dose corticosteroids and were hypogammaglobulinemic. Treatment with immunosuppressants was discontinued for all other patients, and no other infection was observed. Ten patients experienced relapse after a mean of 4 (range, 1-16) months after achieving complete responses.Conclusions: Rituximab appears to have rapid and dramatic efficacy in patients with severe, refractory MMP. The occurrence of severe infections in patients receiving concomitant conventional immunosuppressants supports using rituximab without other immunosuppressants. Controlled prospective studies are warranted to define an optimal treatment protocol.

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Section: Commentmentioning

confidence: 99%

Rituximab for Patients With Refractory Mucous Membrane Pemphigoid

Roux–Villet¹,

Prost-Squarcioni²,

Alexandre³

et al. 2011

Arch Dermatol

129

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“…[375][376][377] Rituximab has been effective as a first-line treatment option for patients with indolent CBCLs with multiple lesions for which local therapy is not effective. [378][379][380][381][382] In a series of 16 patients with PCBCL, 14 patients (87.5%) experienced complete remission, with 35% of these patients experiencing relapse between 6 and 37 months. 382 In another retrospective analysis of 15 patients with indolent CBCLs, the overall objective response rate was 87% (60% with a complete response, 27% with a partial response) with a median follow-up of 36 months.…”

Section: Nccn Recommendationsmentioning

confidence: 99%

“…[378][379][380][381][382] In a series of 16 patients with PCBCL, 14 patients (87.5%) experienced complete remission, with 35% of these patients experiencing relapse between 6 and 37 months. 382 In another retrospective analysis of 15 patients with indolent CBCLs, the overall objective response rate was 87% (60% with a complete response, 27% with a partial response) with a median follow-up of 36 months. 381 The overall response rate was 100% for patients with PCFCL and 60% for those with PCMZL.…”

Section: Nccn Recommendationsmentioning

confidence: 99%

Non-Hodgkin's Lymphomas

Zelenetz

Abramson

Advani

et al. 2011

J Natl Compr Canc Netw

164

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OverviewNon-Hodgkin's lymphomas (NHLs) are a heterogeneous group of lymphoproliferative disorders originating in B-, T-, or natural killer (NK) lymphocytes. In the United States, B-cell lymphomas represent 80% to 85% of the cases, with 15% to 20% being Tcell lymphomas; NK lymphomas are rare. In 2010, an estimated 65,540 new cases of NHL were diagnosed and 20,210 patients died of the disease.1 NHL is the sixth leading site of new cancer diagnoses among men and women, accounting for 4% of new cancer cases and 4% of cancer-related deaths.

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“…Limited series and case reports have demonstrated the interest of the use of rituximab in refractory pemphigus vulgaris, dermatomyositis or lupus [7,8,9]. Rituximab can be used for the treatment of PCFCL, with a high clinical overall response rate [10,11]. It is generally well tolerated, but serious dermatologic adverse events have been reported, such as cutaneous vasculitis [12], Stevens-Johnson syndrome [13] and delayed hypersensitivity reaction [14].…”

Section: Discussionmentioning

confidence: 99%

Focal Rituximab-Induced Edematous Reaction at Primary Cutaneous Follicle Center Lymphoma Lesions: Case Report and Literature Review

et al. 2011

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Primary cutaneous follicle center lymphoma (PCFCL) is the most common cutaneous B cell lymphoma. It is most often indolent and responds well to rituximab. We present a case of transient rituximab-induced edematous lesions located exclusively on tumor papules in a patient treated for PCFCL. Based on this observation and on a review of the literature, we discuss the mechanism of this edematous reaction which does not seem to be allergic. Indeed, this focal reaction observed solely during the first infusion of rituximab is more likely linked with local cytokine release induced by B cell lysis in the skin. This reaction is neither unusual nor severe and should not lead to an interruption of rituximab.

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Rituximab monotherapy for primary cutaneous B-cell lymphoma: response and follow-up in 16 patients

Abstract: On the basis of our results, single-agent treatment with i.v. rituximab appears to be feasible and safe and results in a high rate of durable remissions. Judging from our data, it appears to be an attractive treatment option and should be directly compared with local radiotherapy.

Cited by 63 publications

References 19 publications

Rituximab for Patients With Refractory Mucous Membrane Pemphigoid

Rituximab for Patients With Refractory Mucous Membrane Pemphigoid

Non-Hodgkin's Lymphomas

Focal Rituximab-Induced Edematous Reaction at Primary Cutaneous Follicle Center Lymphoma Lesions: Case Report and Literature Review

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