Unit of Lymphoid Malignancies, Department of Oncology, San Raffaele Scientific Institute, Milan, Italy.
Ophthalmology. 2011 Jan;118(1):24-8. doi: 10.1016/j.ophtha.2010.04.036. Epub 2010 Aug 14.
The tolerability and activity of the intralesional administration of rituximab, a chimeric monoclonal antibody that targets the CD20 antigen, was assessed in patients with conjunctival B-cell lymphoma. The systemic administration of rituximab has varying response rates with different types of lymphoma, generally with a mild toxicity level. Intralesional administration of this drug has increased local disease control in cases of cutaneous mucosa-associated lymphoid tissue (MALT) lymphoma.
This was an interventional pilot study of 3 patients with relapsed CD20+ conjunctival lymphomas treated with intralesional injections of rituximab.
Two patients with conjunctival MALT lymphoma refractory to previous systemic treatment with rituximab and 1 patient with relapsed follicular lymphoma of the eyelid were included in the study.
Patients received 4 weekly intralesional injections followed by 6 monthly injections of undiluted rituximab together with xylocaine 2%.
Side effects and tumor response were assessed before each intralesional injection and at 3-month intervals after treatment conclusion.
The 2 conjunctival MALT lymphoma patients achieved complete remission after intraconjunctival rituximab treatment, which shows that this method of administration can overcome the primary resistance to this monoclonal antibody. The patient with the eyelid follicular lymphoma did not achieve tumor regression after the first intralesional injections of rituximab. In this patient, the addition of autologous serum resulted in lymphoma remission at the end of treatment, suggesting that drug inefficacy can be related to the low bioavailability of effectors in the tumor tissue.
Although follow-up is still short, these preliminary findings suggest that intralesional rituximab is a well-tolerated strategy in marginal-zone and follicular lymphomas of the conjunctiva. An increased bioavailability of effectors in the tumor tissue, by means of the addition of autologous serum, may improve rituximab activity. This strategy could be used in other extranodal CD20+ indolent lymphomas to improve local control, even in patients who are initially refractory to systemic rituximab treatment.
评估靶向 CD20 抗原的嵌合单克隆抗体利妥昔单抗（rituximab）的瘤内给药的耐受性和活性，该药物用于治疗结膜 B 细胞淋巴瘤患者。全身性给予利妥昔单抗治疗不同类型的淋巴瘤，其反应率不同，通常毒性水平较低。该药物的瘤内给药已增加了皮肤黏膜相关淋巴组织（MALT）淋巴瘤的局部疾病控制。
这是一项针对 3 例复发性 CD20+结膜淋巴瘤患者的介入性初步研究，这些患者接受了利妥昔单抗瘤内注射治疗。
该研究纳入了 2 例对先前全身性利妥昔单抗治疗有抗药性的结膜 MALT 淋巴瘤患者和 1 例复发性眼睑滤泡淋巴瘤患者。
患者接受了 4 周的每周瘤内注射，然后是未稀释的利妥昔单抗联合 2%利多卡因的 6 个月每月注射。
在每次瘤内注射前和治疗结束后 3 个月间隔评估副作用和肿瘤反应。
2 例结膜 MALT 淋巴瘤患者在接受眼内利妥昔单抗治疗后达到完全缓解，表明这种给药方式可以克服对该单克隆抗体的原发性耐药性。眼睑滤泡淋巴瘤患者在接受利妥昔单抗的第一次瘤内注射后未出现肿瘤消退。在该患者中，添加自体血清导致治疗结束时淋巴瘤消退，表明药物无效可能与肿瘤组织中效应物的低生物利用度有关。
尽管随访时间仍较短，但这些初步发现表明，眼内利妥昔单抗是结膜边缘区和滤泡性淋巴瘤的一种耐受良好的策略。通过添加自体血清增加肿瘤组织中效应物的生物利用度可能会提高利妥昔单抗的活性。这种策略可用于其他结外 CD20+惰性淋巴瘤，以改善局部控制，甚至在最初对全身性利妥昔单抗治疗有抗药性的患者中也如此。
