Guan Rong-Yan, Tang Xing-Ru, Huang Zou-Fang, Du Jun, Fu Xue-Hang, Lu Guang, Mou Wei-Wei
Department of Hematology, Daqing Oilfield General Hospital, Daqing, Heilongjiang, China.
Department of Clinical Medicine, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Recent Pat Anticancer Drug Discov. 2025;20(1):121-130. doi: 10.2174/0115748928247369231024112003.
Splenic marginal zone Lymphoma (SMZL) is a rare, chronic B lymphocyte proliferative disease. Generally, SMZL is accompanied by circulating atypical villous lymphocytes, known as SMZL with villous lymphocytes. Rituximab is a chimeric monoclonal antibody to CD20; recent but limited studies have confirmed its effectiveness in treating SMZL. Given the low incidence and selection of treatment, statistical comparisons of rituximab monotherapy with other available treatment options with the full range of data from previous clinical studies remain sparse. Here, we report a case of SMZL with villous lymphocytes treated by rituximab monotherapy, which is especially infrequently reported.
A 63-year-old Chinese female was presented to the hospital with complaints of splenomegaly and pain in the spleen area. Immunohistochemistry analysis was positive for IGH, IGK, and IGL clonal rearrangement. Villous lymphocytes were found in peripheral blood and bone marrow, along with further immunotyping results. The case was considered as SMZL with villous lymphocytes. Based on the SMZLSG prognosis assessment, we applied rituximab monotherapy. After eight cycles of rituximab treatment, the patient's condition improved markedly, with blood constituent and size of the spleen returning to normal levels, achieving complete response, with no significant side effect observed.
The patient provides a typical SMZL with villous lymphocytes case treated with rituximab monotherapy. Currently, the main treatment options include splenectomy and rituximab. After synthesizing a series of current views, we put forward our opinion about the selection of therapy for SMZL patients in order to gain maximum benefits for patients in need of treatment.
Our analysis found no statistically significant difference between rituximab monotherapy and rituximab combined with chemotherapy, while rituximab treatments resulted in better therapeutic effects than chemotherapy. Rituximab monotherapy has favorable therapeutic effects and minor adverse effects (AEs) in treating SMZL.
脾边缘区淋巴瘤（SMZL）是一种罕见的慢性B淋巴细胞增殖性疾病。一般来说，SMZL伴有循环中的非典型绒毛状淋巴细胞，即伴有绒毛状淋巴细胞的SMZL。利妥昔单抗是一种针对CD20的嵌合单克隆抗体；近期但有限的研究已证实其治疗SMZL的有效性。鉴于发病率低及治疗选择，将利妥昔单抗单药治疗与其他可用治疗方案进行统计学比较，并纳入以往临床研究的完整数据，此类研究仍然较少。在此，我们报告1例采用利妥昔单抗单药治疗的伴有绒毛状淋巴细胞的SMZL病例，此类报道尤为罕见。
一名63岁中国女性因脾肿大及脾区疼痛就诊。免疫组化分析显示IGH、IGK和IGL克隆重排呈阳性。在外周血和骨髓中发现了绒毛状淋巴细胞，并获得了进一步的免疫分型结果。该病例被诊断为伴有绒毛状淋巴细胞的SMZL。基于SMZLSG预后评估，我们采用了利妥昔单抗单药治疗。经过8个周期的利妥昔单抗治疗，患者病情明显改善，血液成分及脾脏大小恢复至正常水平，达到完全缓解，且未观察到明显副作用。
该患者提供了1例采用利妥昔单抗单药治疗的典型伴有绒毛状淋巴细胞的SMZL病例。目前，主要治疗选择包括脾切除术和利妥昔单抗。综合一系列当前观点后，我们针对SMZL患者的治疗选择提出了自己的看法，以便为有治疗需求的患者带来最大益处。
我们的分析发现，利妥昔单抗单药治疗与利妥昔单抗联合化疗之间无统计学显著差异，但利妥昔单抗治疗的疗效优于化疗。利妥昔单抗单药治疗在治疗SMZL方面具有良好的治疗效果且不良反应较小。
