Gellrich S, Muche J M, Wilks A, Jasch K C, Voit C, Fischer T, Audring H, Sterry W
Department of Dermatology, Venerology and Allergy, Medical Faculty (Charité), Humboldt-University Berlin, Schumannstr. 20/21, 10117 Berlin, Germany.
Br J Dermatol. 2005 Jul;153(1):167-73. doi: 10.1111/j.1365-2133.2005.06659.x.
Primary cutaneous B-cell lymphomas (PCBCLs) are characterized by restriction to the skin and a variable but mostly favourable prognosis. Since 1997 the recombinant, chimeric anti-CD20 antibody rituximab has been used in patients suffering from non-Hodgkin's B-cell lymphomas. Different studies have shown that the effectiveness and safety in the treatment of patients with low-grade follicular lymphoma is comparable to or even higher than the standard CHOP chemotherapy. So far it has been unclear whether an extended duration of therapy leads to a benefit for the patients with PCBCL.
To evaluate the objective response rate, time to progression, remission quality and histological changes and to compare our data with the literature.
PATIENTS/METHODS: Ten patients with PCBCL [eight with follicle centre cell lymphoma (FCCL), one with marginal zone lymphoma (MZL) and one with diffuse large B-cell lymphoma of the leg (DLBCL)] were treated by intravenous application of a chimeric antibody against the CD20 transmembrane antigen (rituximab) with a dosage of eight cycles, 375 mg m(-2) body surface, weekly.
The treatment regimen resulted in clinical overall response in 9 of 10 patients, in particular there were seven complete responses (70%) plus two partial responses (20%). The median duration of remission (durable remission, DR) is 23 months (4-30 months) to date. Histological assessment of responses in four patients showed no tumour-specific infiltration. In two patients histology revealed a residual infiltration and in one patient an increasing infiltration. In two patients no histology was taken after treatment; one patient developed a new lesion. No severe side-effects occurred. Observed side-effects were two bacterial infections, two patients with shivering during infusion, one patient with sweating for months and one patient with persisting itching. As expected the B-cell count in peripheral blood was depressed in all patients after infusion.
Intravenous therapy with eight cycles of the anti-CD20 antibody rituximab is a non-toxic and effective treatment for a subset of patients with PCBCL (relapsed, aggressive entity, old patients, multiple lesions) with a long DR.
原发性皮肤B细胞淋巴瘤（PCBCL）的特点是局限于皮肤，预后不一但大多良好。自1997年以来，重组嵌合抗CD20抗体利妥昔单抗已用于治疗非霍奇金B细胞淋巴瘤患者。不同研究表明，其在治疗低度滤泡性淋巴瘤患者中的有效性和安全性与标准CHOP化疗相当，甚至更高。到目前为止，尚不清楚延长治疗时间是否会使PCBCL患者受益。
评估客观缓解率、疾病进展时间、缓解质量和组织学变化，并将我们的数据与文献进行比较。
患者/方法：10例PCBCL患者[8例滤泡中心细胞淋巴瘤（FCCL）、1例边缘区淋巴瘤（MZL）和1例腿部弥漫性大B细胞淋巴瘤（DLBCL）]接受静脉注射针对CD20跨膜抗原的嵌合抗体（利妥昔单抗）治疗，剂量为375mg/m²体表面积，每周1次，共8个周期。
该治疗方案使10例患者中的9例获得临床总体缓解，其中7例完全缓解（70%），2例部分缓解（20%）。截至目前，缓解的中位持续时间（持久缓解，DR）为23个月（4 - 30个月）。对4例患者缓解情况的组织学评估显示无肿瘤特异性浸润。2例患者组织学显示有残留浸润，1例患者浸润增加。2例患者治疗后未进行组织学检查；1例患者出现新病灶。未发生严重副作用。观察到的副作用有2例细菌感染、2例患者输液时寒战、1例患者数月出汗、1例患者持续瘙痒。正如预期的那样，所有患者输液后外周血B细胞计数均降低。
静脉注射8个周期的抗CD20抗体利妥昔单抗对部分PCBCL患者（复发、侵袭性类型、老年患者、多处病灶）是一种无毒且有效的治疗方法，持久缓解期长。
