Department of Dermatology, Complejo Hospitalario Universitario Insular Materno-Infantil, Gran Canaria, Las Palmas de GC, Spain.
Br J Dermatol. 2012 Jul;167(1):174-9. doi: 10.1111/j.1365-2133.2012.10902.x.
Intravenous rituximab is a safe and effective option for the treatment of systemic non-Hodgkin B-cell lymphoma. The effectiveness of intralesional rituximab (ILR) in primary cutaneous B-cell lymphomas (PCBL) has been described in a small number of patients.
To evaluate the effectiveness, tolerance and adverse effects of ILR in patients with follicle centre (FCL) and marginal zone (MZL) PCBL.
This was an epidemiological observational multicentre study of patients with PCBL treated with ILR.
Seventeen patients with MZL and 18 with FCL PCBL were included. The median number of lesions treated was two per patient. The treatment regimen used in 74% of the patients was a course of three injections in a single week at 1-month intervals. The dose per lesion and day of treatment was 10 mg in 71% of the patients. The median cumulative dose of rituximab per lesion was 60 mg (range 13-270) and per patient was 150 mg (range 20-360 mg). Complete response (CR) and partial response were achieved in 71% and 23% of patients, respectively. The median time to CR in patients who received 10 mg of ILR per lesion was 8 weeks. Similar response rates were observed in MZL and FCL. Median disease-free survival was 114·1 weeks. No parameters that significantly predicted CR were identified. Adverse reactions were recorded in 19 patients; the most frequent was localized pain at the injection site. Median follow-up was 21 months.
Intralesional rituximab is a well-tolerated and effective treatment for FCL and MZL PCBL. It should be considered a useful alternative in patients with recurrent lesions and in which the sequelae of radiotherapy or surgery would be significant.
静脉注射利妥昔单抗是治疗系统性非霍奇金 B 细胞淋巴瘤的安全有效的选择。已在少数患者中描述了原发性皮肤 B 细胞淋巴瘤（PCBL）中病灶内利妥昔单抗（ILR）的有效性。
评估 ILR 治疗滤泡中心（FCL）和边缘区（MZL）PCBL 患者的有效性、耐受性和不良反应。
这是一项针对接受 ILR 治疗的 PCBL 患者的流行病学观察性多中心研究。
18 例 FCL 和 17 例 MZL PCBL 患者纳入研究。每位患者治疗的病变中位数为 2 个。74%的患者采用的治疗方案是在 1 个月的间隔内每周进行 3 次注射的 1 个疗程。71%的患者每病变和治疗日的剂量为 10mg。每病变的利妥昔单抗累积剂量中位数为 60mg（范围 13-270），每位患者为 150mg（范围 20-360mg）。分别有 71%和 23%的患者获得完全缓解（CR）和部分缓解（PR）。接受 10mg 每病变 ILR 的患者的 CR 中位时间为 8 周。MZL 和 FCL 中观察到相似的反应率。无疾病生存的中位时间为 114.1 周。未确定可显著预测 CR 的参数。19 例患者记录到不良反应；最常见的是注射部位局部疼痛。中位随访时间为 21 个月。
病灶内利妥昔单抗是治疗 FCL 和 MZL PCBL 的一种耐受性良好且有效的治疗方法。对于有复发性病变且放疗或手术的后遗症会很显著的患者，应考虑将其作为一种有用的替代方法。
