Systemic therapy with cyclophosphamide and anti-CD20 antibody (rituximab) in relapsed primary cutaneous B-cell lymphoma: a report of 7 cases.
BACKGROUND
Rituximab, a chimeric antibody directed against CD20, has a high therapeutic value in refractory/relapsed low-grade or follicular B-cell non-Hodgkin's lymphomas as a monotherapy or in combination with polychemotherapy.


OBJECTIVE
We sought to evaluate the clinical activity and toxicity of a schedule foreseeing the use of intravenous rituximab preceded by single-dose cyclophosphamide in the treatment of patients with primary cutaneous B-cell lymphoma who progressed and relapsed after chemotherapy.


METHODS
A total of 7 patients were treated; 4 had both cutaneous lesions and nodal or visceral involvement. All the patients had been previously treated with at least 1 standard chemotherapy regimen, and 4 with 2 or more, with a median response duration of 8 months. Immunohistochemistry on frozen sections was performed with monoclonal antibodies directed against CD20, CD55, and CD59 before rituximab treatment.


RESULTS
The overall objective response rate was 85.7%, with a complete response in 5 patients; treatment was well tolerated in all cases. After a median follow-up of 13 months, 2 patients showed a cutaneous relapse. The response durations of the remaining patients who were disease-free are now 5, 7, 17, and 18 months. No relationship was found between CD55 and CD59 expression and the clinical outcome.


CONCLUSIONS
Although a longer follow-up period is needed to confirm these data, our results are encouraging, particularly in terms of disease-free survival.
Fierro
Maria T
MT
Department of Medical and Surgical Specialties, First Section of Dermatology, University of Turin, Torino, Italy.
Savoia
Paola
P
Quaglino
Pietro
P
Novelli
Mauro
M
Barberis
Manuela
M
Bernengo
Maria G
MG
D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000378:metabolism; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D000069283:Rituximab; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000276:immunology
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D000069283:Rituximab; D003520:Cyclophosphamide