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Systemic therapy of primary cutaneous B-cell lymphoma, marginal zone type, with rituximab, a chimeric anti-CD20 monoclonal antibody.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Soda, Ryo Costanzo, Antonio Cantonetti, Maria Orlandi, Augusto Bianchi, Leonardo Chimenti, Sergio |
| Copyright Year | 2001 |
| Abstract | and the strong CD20 positivity prompted us to use Rituximab, as a Sir, single agent, at the dosage of 375 mg/m2 once a week for 4 weeks as According to the European Organization for Research and an intravenous infusion in 1 litre of normal saline. At the end of this Treatment of Cancer (EORTC) classi cation, the major subschedule, the more recent 3 nodules disappeared and the other lesions types of primary cutaneous B-cell lymphomas are follicle were reduced in size by at least 50%. One of these persistent lesions was biopsied. A substantial reduction in the neoplastic in ltrate, centre-cell lymphoma and immunocytoma/marginal zone mainly involving the interstitial and mantle follicular components, lymphoma, both characterized by indolent behaviour and was observed (compare Fig. 2a with 2e).The immunohistochemical favourable prognosis in the majority of patients (1). staining revealed down-regulation of CD20 antigen expression (comRadiotherapy, surgery excision and intralesional interferon are pare Fig. 2b and 2d with 2f ) and diŒerent distribution of immunoglobulin light-chain positivity. After 6 months of follow-up, clearing the preferred treatments in patients with solitary or localized or partial remission of the pre-existing lesions and absence of a new skin lesions (2). Multiagent chemotherapy alone or associated relapse completed the clinical picture. with interferon-a or with radiotherapy is limited to multifocal skin lesions (3). Rituximab, a genetically engineered anti-CD20 monoclonal antibody, already approved for the treatment of nonDISCUSSION Hodgkin's lymphomas (3, 4), has been recently used in primary cutaneous B-cell lymphoma (5). Marginal zone B-cell lymphoma, characterized clinically by The recent observation of a patient aŒected by a primary solitary or cluster erythematous papules, nodules or plaques, multifocal B-cell cutaneous lymphoma, marginal zone type, usually shows an indolent clinical behaviour, slow evolution prompted us to use Rituximab as a single agent, with and good prognosis (3). satisfactory results. Rituximab is a monoclonal antibody directed against the B-cell speci c antigen CD20, which is a 297 amino acid phosphoprotein expressed on pro-B-cells and B-cells, and CASE REPORT overexpressed on malignant B-cells. CD20 antigen seems to A 38-year-old man presented a 10-year history of progressive erythbe involved in B-cell diŒerentiation and proliferation (6). This ematous nodules located on the back and thorax with no lymphadenoantibody, binding with high a nity to CD20 antigen, mediates pathies (Fig. 1). A total of 8 lesions, 1–5 cm in size, was counted. The complement-dependent cell lysis and antibody-dependent celpatient, who had not received any previous treatment, was otherwise lular cytotoxicity. It has also been shown to sensitize chemoin good health. Skin biopsies showed diŒuse lymphocytic in ltrate with few follicresistant human lymphoma cell lines and to induce apoptosis ular centres in the dermis sparing the subepidermal zone and reaching in vitro (7). In most patients, this treatment is well tolerated the subcutaneous tissue (Fig. 2a). Small lymphocytes and monowithout serious systemic adverse eŒects. Temporary peripheral cytoid cells were the main neoplastic component. Immunohistoblood B-cell depletion may occur, but it has not been associated chemical staining revealed positivity for CD20 (Fig. 2b, d) and for l-immunoglobulin light chains (Fig. 2c), whereas k-light chains, CD5 with immunode ciency or signi cant changes in immunoand CD10 were negative. A scattered CD3 positivity was also observed globulin G levels (8). Recent data demonstrate complete or within and around the neoplastic in ltrate. Staging of the patient (TC more often partial remission in half of the patients with total body, bone marrow biopsy, laboratory ndings) showed no systemic relapsed low-grade lymphomas. The follow-up abnormalities and anti-Borrelia burgdorferi antibodies were absent. showed a median remission of about 1 year (9). The clinical picture, the immunohistological ndings and the absence of extracutaneous localizations were indicative of a primary cutaneous We used Rituximab as a rst-choice agent for the treatment B-cell lymphoma of marginal zone type. The multifocal localization of a disseminated cutaneous marginal zone lymphoma with no additional chemotherapy, and observed a good therapeutic response and no signi cant side-eŒects. Furthermore, we observed the downregulation of CD20 antigen on neoplastic cells at the end of therapy. The loss of CD20 expression is a phenomenon already reported in the literature, which seems to occur only rarely (10) and may decrease the e cacy of this treatment. However, Treon et al. reported that interferon-c at pharmacologically achievable concentrations induced CD20 expression on B-lymphocytes (11). It will be interesting to observe the clinical response to an interferon-c/Rituximab combined treatment in patients with CD20+ lymphoproliferative diseases. |
| File Format | PDF HTM / HTML |
| DOI | 10.1080/000155501750376339 |
| PubMed reference number | 11558880 |
| Journal | Medline |
| Volume Number | 81 |
| Issue Number | 3 |
| Alternate Webpage(s) | https://art.torvergata.it/retrieve/handle/2108/51960/314226/Systemic%20Therapy%20of%20Primary%20Cutaneous%20B-cell%20Lymphoma,%20Marginal%20Zone%20Type,%20ACTA%20DERMATO-VENEREOLOGICA,%202001%20vol.%2081,%20p.%20207-208.pdf |
| Alternate Webpage(s) | https://www.medicaljournals.se/acta/download/10.1080/000155501750376339/ |
| Journal | Acta dermato-venereologica |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
