Rituximab (anti-CD20 monoclonal antibody) as single first-line therapy for patients with follicular lymphoma with a low tumor burden: clinical and molecular evaluation.
The clinical activity of rituximab, a chimeric monoclonal antibody which binds to the CD20 antigen, was evaluated as a single first-line therapy for patients with follicular non-Hodgkin lymphoma (NHL). Fifty patients with follicular CD20(+) NHL and a low tumor burden were analyzed for clinical and molecular responses. They received 4 weekly infusions of rituximab at a dose of 375 mg/m(2). The response rate a month after treatment (day 50) was 36 of 49 (73%), with 10 patients in complete remission, 3 patients in complete remission/unconfirmed, and 23 patients in partial remission. Ten patients had stable disease, and the disease progressed in 3 patients. One of 13 (8%) patients in complete remission, 9 of 23 (39%) patients in partial remission, and 5 of 10 (50%) patients with stable disease exhibited disease progression during the first year. Within the study population, 32 patients were initially informative for polymerase chain reaction (PCR) data on bcl-2-J(H) rearrangement. On day 50, 17 of 30 patients (57%) were negative for bcl-2-J(H) rearrangement in peripheral blood, and 9 of 29 (31%) were negative in bone marrow; a significant association was observed between molecular and clinical responses (P <.0001). At month 12, 16 of 26 patients (62%) were PCR negative in peripheral blood. These results indicate that early molecular responses can be sustained for up to 12 months and that this response is highly correlated with progression-free survival. Rituximab has a high clinical activity and a low toxicity and induces a high complete molecular response rate in patients with follicular lymphoma and a low tumor burden.
Colombat
P
P
CHU Bretonneau, Tours, France.
Salles
G
G
Brousse
N
N
Eftekhari
P
P
Soubeyran
P
P
Delwail
V
V
Deconinck
E
E
Haïoun
C
C
Foussard
C
C
Sebban
C
C
Stamatoullas
A
A
Milpied
N
N
Boué
F
F
Taillan
B
B
Lederlin
P
P
Najman
A
A
Thièblemont
C
C
Montestruc
F
F
Mathieu-Boué
A
A
Benzohra
A
A
Solal-Céligny
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000633:toxicity; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000032:analysis; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000633:toxicity; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015321:Gene Rearrangement; D019254:Genes, bcl-2; D006801:Humans; D007133:Immunoglobulin Joining Region; D008224:Lymphoma, Follicular / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012074:Remission Induction; D000069283:Rituximab; D013997:Time Factors; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D000970:Antineoplastic Agents; D007133:Immunoglobulin Joining Region; D000069283:Rituximab