Anti-CD20 Monoclonal Antibody as New Treatment Modality for B-Cell Lymphoma

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概要

• 論文の詳細を見る

• The treatment of advanced-stage non-Hodgkin's lymphoma over 50 years was based primarily on chemotherapy and radiotherapy. However, The optimal treatment of follicular lymphoma is not yet determined. In patients with a low tumor burden watch and wait strategy until progression has no negative influence on survival. The chimeric human mouse anti-CD20 monoclonal antibody rituximab is a human IgGlk antibody, with mouse variable regions isolated from a murine anti-CD20 antibody. In vitro studies demonstrated that IDEC2B8 is able to lyse CD20 positive cells using complement dependent (CDC) or antibody-dependent cell-mediated cytotoxicity (ADCC). Flow-cytometry and immunohistochemical staining of B-cell lymphoma in 150 patients showed that CD20 antigen was expressed in 95% of patients. There was a good correlation in the incidence of expression between CD20 and CD19 (r=0,89). Discrepancy in expression of CD20 and CD19 was observed in 6 cases of diffuse large B-cell lymphoma, in which CD20 did not express in spite of strong expression of CD19. The clinical response seems to correlate with the intensity of CD20 expression rather than the incidence. We experienced a case of follicular lymphoma successfully treated with rituximab as single therapy. A 40 years old male with follicular lymphoma in stage IV, who had been heavily treated with chemotherapy, was treated with rituximab as single therapy at a dose of 375mg/m^2 by intravenous infusion every I week for a total of 8 doses. Rituximab was administered at an initial rate of 25mg/hr to avoid infusion-related reactions. The bulky tumors began to decrease in size after 2 weeks and the patient achieved complete remission (CR) after completion of 8 doses. No relapse has been observed for more than 2 years until now. Japanese phase II trial of rituximab for pretreated follicular lymphoma showed 60% of response rate as compatible to those obtained in the West. In conclusion, rituximab has high clinical activity in patients with follicular non-Hodgkin's lymphoma, whereas response duration remains to be determined. Confirmation of CD20 expression on tumor cells is essential to predict the response to rituximab in B-cell lymphoma.

• 日本組織細胞化学会の論文

著者

• HOTTA Tomomitsu

  Division of Hematology and Rheumatology, Tokai University School of Medicine

• Hotta Tomomitsu

  Division Of Hematology Department Of Medicine Tokai University School Of Medicine

関連論文

• Multicenter Prospective Study of Clonal Complications in Adult Aplastic Anemia Patients following Recombinant Human Granulocyte Colony-Stimulating Factor (Lenograstim) Administration
• Anti-CD20 Monoclonal Antibody as a New Treatment Modality for B-Cell Lymphoma
• Anti-CD20 Monoclonal Antibody as New Treatment Modality for B-Cell Lymphoma

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