Rituximab

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Abstract
▴ Rituximab is a chimaeric monoclonal antibody which specifically binds to the CD20 antigen on normal and malignant B lymphocytes. It produces antibody-dependent cell- and complement-mediated cytotoxicity in these cells. ▴ Rituximab reduced peripheral B lymphocyte counts by ≈90% within 3 days in patients with relapsed indolent lymphoma. Counts remained depleted for 6 months and recovered by months 9 to 12 after 4 doses of rituximab 375 mg/m2 once weekly. ▴ Clinical response rates were 46 and 48% in 2 non-comparative trials in patients with relapsed indolent lymphoma. The rate of response to rituximab appeared to be markedly higher in patients with follicular lymphoma than in those with small lym-phocytic disease (56 or 60% versus 13 or 15%). ▴ 85 to 94% of patients reported adverse events during clinical trials of rituximab; 90% of events were mild or moderate. The most common adverse event, a transient set of flu-like symptoms during the first infusion in approximately 50 to 87% of patients, generally resolved completely in <3 hours. Diphenhydramine and/or paracetamol was administered to some patients. ▴ In 10% of patients, the flu-like symptoms during the first infusion were accompanied by broncho-spasm and/or hypotension or severe cytokine release syndrome. Patients were generally able to complete treatment after these symptoms resolved.