NEW YORK (Reuters Health) – A small study indicates that most patients with cutaneous B-cell lymphoma who respond well to rituximab relapse after about two years.
On the positive side, the researchers found that rituximab treatment is not associated with extracutaneous extension of disease, and conventional treatment such as radiotherapy remains effective after relapse.
Dr. Marc Beyer, at Charite-Universitatsmedizin Berlin, Germany, and colleagues note in their paper in the British Journal of Dermatology online June 25 that intravenous rituximab induces remission in primary cutaneous B-cell lymphoma (CBCL) but information about long-term outcomes has been patchy.
The team therefore analyzed data on 18 patients with CBCL treated with intravenous rituximab and followed for up to 11 years. Although the number is small, “this is the largest cohort treated with rituximab i.v. published so far,” the authors point out.
The patients received from 4 to 14 infusions of rituximab, usually at weekly intervals. In 13 patients all clinical lymphoma lesions resolved (complete response) and in 3 patients the size or number of lesions decreased (partial response), for an overall response rate of 89%, according to the report.
Median follow-up was 52 months. Thirteen of the 16 responders relapsed after a median of 25 months, the investigators report.
Conversely, three of the patients (19%) had a durable response with no recurrence during 30 to 113 months of follow-up. “Therefore, rituximab therapy can induce long-term remissions in patients with CBCLs,” they point out.
All relapses involved the skin only. “Relapses were treated in all cases successfully with standard therapeutic regimens, e.g. radiotherapy,” the authors note. In four cases, re-treatment with rituximab was initiated, with complete response achieved in three.
Regarding safety, there were no instances of reactivation of viral infection, a concern with biologic immunosuppressives including rituximab, and none of the patients experienced a relapse with an aggressive course.
“Taken together our data as well as data from the literature suggest that in general rituximab can safely be administered to patients with CBCL,” Dr. Beyer and colleagues conclude. Given the good response to retreatment after relapse, they add, “We do not favour maintenance therapy.”
An automated response to an email sent to Dr. Beyer indicated that he was unavailable for further comments before the posting deadline.
Source: Long-term outcome of intravenous therapy with rituximab in patients with primary cutaneous B-cell lymphomas
Br J Dermatol 2013.
