Fierro Maria T, Savoia Paola, Quaglino Pietro, Novelli Mauro, Barberis Manuela, Bernengo Maria G
Department of Medical and Surgical Specialties, First Section of Dermatology, University of Turin, Torino, Italy.
J Am Acad Dermatol. 2003 Aug;49(2):281-7. doi: 10.1067/s0190-9622(03)00855-7.
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.
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.
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.
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.
Although a longer follow-up period is needed to confirm these data, our results are encouraging, particularly in terms of disease-free survival.
利妥昔单抗是一种针对CD20的嵌合抗体，作为单一疗法或与多药化疗联合使用，在难治性/复发性低度或滤泡性B细胞非霍奇金淋巴瘤中具有很高的治疗价值。
我们试图评估一种治疗方案的临床活性和毒性，该方案为先使用单剂量环磷酰胺，然后静脉注射利妥昔单抗，用于治疗化疗后进展和复发的原发性皮肤B细胞淋巴瘤患者。
共治疗7例患者；4例既有皮肤病变，又有淋巴结或内脏受累。所有患者此前均接受过至少1种标准化疗方案治疗，4例接受过2种或更多种方案治疗，中位缓解持续时间为8个月。在利妥昔单抗治疗前，用针对CD20、CD55和CD59的单克隆抗体对冰冻切片进行免疫组织化学检测。
总体客观缓解率为85.7%，5例患者完全缓解；所有病例对治疗耐受性良好。中位随访13个月后，2例患者出现皮肤复发。其余无病患者的缓解持续时间目前分别为5、7、17和18个月。未发现CD55和CD59表达与临床结果之间存在关联。
尽管需要更长的随访期来证实这些数据，但我们的结果令人鼓舞，尤其是在无病生存方面。
