The evaluation and optimal use of rituximab in lymphoid malignancies

Tadeusz Robak1, Pawel Robak2, Piotr Smolewski21Department of Hematology, 2Experimental Hematology, Medical University of Ł&oacute;dź, Ł&oacute;dź, PolandAbstract: Rituximab is an IgG1, chimeric monoclonal antibody (mAb) containing murine light- and heavy-chain variable-region sequenc...

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Autores principales:	Smolewski P, Robak T, Robak P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Diseases of the blood and blood-forming organs RC633-647.5
Acceso en línea:	https://doaj.org/article/f0ea90724741473e8a0a5bb0108a6505
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spelling	oai:doaj.org-article:f0ea90724741473e8a0a5bb0108a65052021-12-02T02:41:37ZThe evaluation and optimal use of rituximab in lymphoid malignancies1179-9889https://doaj.org/article/f0ea90724741473e8a0a5bb0108a65052012-01-01T00:00:00Zhttp://www.dovepress.com/the-evaluation-and-optimal-use-of-rituximab-in-lymphoid-malignancies-a8988https://doaj.org/toc/1179-9889Tadeusz Robak1, Pawel Robak2, Piotr Smolewski21Department of Hematology, 2Experimental Hematology, Medical University of Ł&oacute;dź, Ł&oacute;dź, PolandAbstract: Rituximab is an IgG1, chimeric monoclonal antibody (mAb) containing murine light- and heavy-chain variable-region sequences and human constant-region sequences. Rituximab targets the CD20 molecule expressed on normal and malignant B-lymphocytes. At present, rituximab is the most important mAb of clinical value in patients with B-cell lymphoid malignancies. Since approval in 1997, rituximab has become widely used in chronic lymphocytic leukemia (CLL), follicular lymphoma (FL), mantle cell lymphoma (MCL), and diffused large B-cell lymphoma (DLBCL) when combined with chemotherapy. Currently, rituximab is commonly combined with first-line chemotherapy for FL and should be offered as maintenance therapy to all appropriate patients with this disease. Randomized Phase III trials demonstrated the superiority of rituximab added to CHOP chemotherapy against CHOP chemotherapy alone in patients with DLBCL. Rituximab alone has limited activity in MCL but can be used in MCL in combination with chemotherapy, despite the benefits not being as impressive as when used against other lymphoma entities. In addition, for the less frequent B-cell lymphomas, small series show considerable activity for most of these entities. Fludarabine and rituximab combination therapies in CLL yielded promising results in several studies. Two large Phase III randomized trials demonstrated the superiority of chemoimmunotherapy with rituximab compared with chemotherapy alone in previously untreated and refractory/relapsed patients with CLL. Therefore, it can be concluded that rituximab, with only few exceptions, can generally be accepted as a standard component of anti B-cell non-Hodgkin&#39;s lymphoma therapies. In this review, the pharmacology, mode of action, pharmacokinetics, and current place in the therapy of B-cell lymphoid malignancies of rituximab are presented. In addition, an overview of studies conducted to date and optimal use of this drug, including timing and doses, is presented.Keywords: chronic lymphocytic leukemia, combined therapy, rituximab, DLBCL, follicular lymphoma, NHL, side effects, pharmacokineticsSmolewski PRobak TRobak PDove Medical PressarticleDiseases of the blood and blood-forming organsRC633-647.5ENBlood and Lymphatic Cancer: Targets and Therapy, Vol 2012, Iss default, Pp 1-16 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the blood and blood-forming organs RC633-647.5
spellingShingle	Diseases of the blood and blood-forming organs RC633-647.5 Smolewski P Robak T Robak P The evaluation and optimal use of rituximab in lymphoid malignancies
description	Tadeusz Robak1, Pawel Robak2, Piotr Smolewski21Department of Hematology, 2Experimental Hematology, Medical University of Ł&oacute;dź, Ł&oacute;dź, PolandAbstract: Rituximab is an IgG1, chimeric monoclonal antibody (mAb) containing murine light- and heavy-chain variable-region sequences and human constant-region sequences. Rituximab targets the CD20 molecule expressed on normal and malignant B-lymphocytes. At present, rituximab is the most important mAb of clinical value in patients with B-cell lymphoid malignancies. Since approval in 1997, rituximab has become widely used in chronic lymphocytic leukemia (CLL), follicular lymphoma (FL), mantle cell lymphoma (MCL), and diffused large B-cell lymphoma (DLBCL) when combined with chemotherapy. Currently, rituximab is commonly combined with first-line chemotherapy for FL and should be offered as maintenance therapy to all appropriate patients with this disease. Randomized Phase III trials demonstrated the superiority of rituximab added to CHOP chemotherapy against CHOP chemotherapy alone in patients with DLBCL. Rituximab alone has limited activity in MCL but can be used in MCL in combination with chemotherapy, despite the benefits not being as impressive as when used against other lymphoma entities. In addition, for the less frequent B-cell lymphomas, small series show considerable activity for most of these entities. Fludarabine and rituximab combination therapies in CLL yielded promising results in several studies. Two large Phase III randomized trials demonstrated the superiority of chemoimmunotherapy with rituximab compared with chemotherapy alone in previously untreated and refractory/relapsed patients with CLL. Therefore, it can be concluded that rituximab, with only few exceptions, can generally be accepted as a standard component of anti B-cell non-Hodgkin&#39;s lymphoma therapies. In this review, the pharmacology, mode of action, pharmacokinetics, and current place in the therapy of B-cell lymphoid malignancies of rituximab are presented. In addition, an overview of studies conducted to date and optimal use of this drug, including timing and doses, is presented.Keywords: chronic lymphocytic leukemia, combined therapy, rituximab, DLBCL, follicular lymphoma, NHL, side effects, pharmacokinetics
format	article
author	Smolewski P Robak T Robak P
author_facet	Smolewski P Robak T Robak P
author_sort	Smolewski P
title	The evaluation and optimal use of rituximab in lymphoid malignancies
title_short	The evaluation and optimal use of rituximab in lymphoid malignancies
title_full	The evaluation and optimal use of rituximab in lymphoid malignancies
title_fullStr	The evaluation and optimal use of rituximab in lymphoid malignancies
title_full_unstemmed	The evaluation and optimal use of rituximab in lymphoid malignancies
title_sort	evaluation and optimal use of rituximab in lymphoid malignancies
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/f0ea90724741473e8a0a5bb0108a6505
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The evaluation and optimal use of rituximab in lymphoid malignancies

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