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Journal of Clinical Oncology, Vol 18, Issue 2 (January), 2000: 317
© 2000 American Society for Clinical Oncology

European Phase II Study of Rituximab (Chimeric Anti-CD20 Monoclonal Antibody) for Patients With Newly Diagnosed Mantle-Cell Lymphoma and Previously Treated Mantle-Cell Lymphoma, Immunocytoma, and Small B-Cell Lymphocytic Lymphoma

By James M. Foran, Ama Z. S. Rohatiner, David Cunningham, Razvan A. Popescu, Philippe Solal-Celigny, Michele Ghielmini, Bertrand Coiffier, Peter W. M. Johnson, Christian Gisselbrecht, Felix Reyes, John A. Radford, Eric M. Bessell, Bertrand Souleau, Aziz Benzohra, T. Andrew Lister

From the Imperial Cancer Research Fund Medical Oncology Unit, St Bartholomew’s Hospital, London; Department of Medicine, Royal Marsden Hospital, Sutton; Imperial Cancer Research Fund Cancer Medicine Unit, St. James’ University Hospital, Leeds; Cancer Research Campaign Department of Medical Oncology, Christie Hospital, Manchester; and Department of Clinical Oncology, Nottingham City Hospital, Nottingham, United Kingdom; Centre Jean Bernard, Le Mans; Department of Hematology, Centre Hospitalier Lyon Sud, Lyon; Department of Hematology, Hopital St Louis, Paris; Department of Hematology, Hopital Henri Mondor, Creteil; Service d’Hematologie, Hopital d’Instructions des Armees Percy, Clamart; and Roche Pharmaceuticals, Neuilly, France; and Servizio Oncologico, Ospedale San Giovanni, Bellinzona, Switzerland.

Address reprint requests to James M. Foran, MD, ICRF Medical Oncology Unit, St Bartholomew’s Hospital, 45 Little Britain, London EC1A 7BE United Kingdom; email foran{at}icrf.icnet.uk

PURPOSE: Mantle-cell lymphoma (MCL), immunocytoma (IMC), and small B-cell lymphocytic lymphoma (SLL) are B-cell malignancies that express CD20 and are incurable with standard therapy. A multicenter phase II study was conducted to assess the toxicity and the overall response rates (RR) and complete response (CR) rates to rituximab (chimeric anti-CD20 monoclonal antibody).

PATIENTS AND METHODS: Between January 1997 and January 1998, 131 patients with newly diagnosed MCL (MCL1; n = 34) and previously treated MCL (MCL2; n = 40), IMC (n = 28), and SLL (n = 29) received rituximab 375 mg/m2/wk for 4 weeks via intravenous infusion. Restaging studies were performed 1 and 2 months after treatment. An analysis of the duration of response was conducted in December 1998.

RESULTS: Eleven patients were unassessable, including one who died of splenic rupture after the first infusion. The RR among the 120 assessable patients was 30% (36 of 120 patients). The RR by histology was as follows: MCL1, 38%; MCL2, 37%; IMC, 28%; and SLL, 14%. Ten patients, all with MCL, achieved CR. The median duration of response in MCL was 1.2 years. Immediate side effects were common and usually responded to adjustments in the infusion rate. There were 31 episodes of infection after treatment; most cases were mild. Cardiac arrhythmia and ophthalmologic side effects occurred in 10 and nine patients, respectively, including one case of severe loss of visual acuity.

CONCLUSION: Single-agent rituximab has moderate activity in MCL and IMC but only limited activity in SLL. The duration of response in MCL was similar to that previously reported in follicular lymphoma. Its use in combination with cytotoxic chemotherapy to increase the CR rate is warranted in MCL and IMC.


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B. Bellosillo, N. Villamor, A. Lopez-Guillermo, S. Marce, J. Esteve, E. Campo, D. Colomer, and E. Montserrat
Complement-mediated cell death induced by rituximab in B-cell lymphoproliferative disorders is mediated in vitro by a caspase-independent mechanism involving the generation of reactive oxygen species
Blood, November 1, 2001; 98(9): 2771 - 2777.
[Abstract] [Full Text] [PDF]


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BloodHome page
D. Huhn, C. von Schilling, M. Wilhelm, A. D. Ho, M. Hallek, R. Kuse, W. Knauf, U. Riedel, A. Hinke, S. Srock, et al.
Rituximab therapy of patients with B-cell chronic lymphocytic leukemia
Blood, September 1, 2001; 98(5): 1326 - 1331.
[Abstract] [Full Text] [PDF]


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BloodHome page
M. V. Dhodapkar, J. L. Jacobson, M. A. Gertz, S. E. Rivkin, G. D. Roodman, J. M. Tuscano, M. Shurafa, R. A. Kyle, J. J. Crowley, and B. Barlogie
Prognostic factors and response to fludarabine therapy in patients with Waldenstrom macroglobulinemia: results of United States intergroup trial (Southwest Oncology Group S9003)
Blood, July 1, 2001; 98(1): 41 - 48.
[Abstract] [Full Text] [PDF]


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JCOHome page
J. C. Byrd, T. Murphy, R. S. Howard, M. S. Lucas, A. Goodrich, K. Park, M. Pearson, J. K. Waselenko, G. Ling, M. R. Grever, et al.
Rituximab Using A Thrice Weekly Dosing Schedule in B-Cell Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma Demonstrates Clinical Activity and Acceptable Toxicity
J. Clin. Oncol., April 15, 2001; 19(8): 2153 - 2164.
[Abstract] [Full Text] [PDF]


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J. Leukoc. Biol.Home page
B. Jahrsdörfer, G. Hartmann, E. Racila, W. Jackson, L. Mühlenhoff, G. Meinhardt, S. Endres, B. K. Link, A. M. Krieg, and G. J. Weiner
CpG DNA increases primary malignant B cell expression of costimulatory molecules and target antigens
J. Leukoc. Biol., January 1, 2001; 69(1): 81 - 88.
[Abstract] [Full Text]


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Clin. Cancer Res.Home page
A. Goel, S. Augustine, J. Baranowska-Kortylewicz, D. Colcher, B. J. M. Booth, G. Pavlinkova, M. Tempero, and S. K. Batra
Single-Dose versus Fractionated Radioimmunotherapy of Human Colon Carcinoma Xenografts Using 131I-labeled Multivalent CC49 Single-chain Fvs
Clin. Cancer Res., January 1, 2001; 7(1): 175 - 184.
[Abstract] [Full Text]


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The OncologistHome page
J. D. Hainsworth
Monoclonal Antibody Therapy in Lymphoid Malignancies
Oncologist, October 1, 2000; 5(5): 376 - 384.
[Abstract] [Full Text]



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