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Rituximab Is Active in Lymphocyte-Predominant Hodgkin’s Disease

Rituximab Is Active in Lymphocyte-Predominant Hodgkin’s Disease

We designed a phase II trial to determine the efficacy of the chimeric anti-CD20 monoclonal antibody rituximab (Rituxan) in lymphocyte-predominant Hodgkin’s disease (LPHD). A unique subtype of Hodgkin’s disease that expresses the CD20 antigen, LPHD has been historically and effectively treated with radiotherapy and/or chemotherapy. However, a subset of patients experience recurrence, and significant treatment-related morbidity and mortality have been reported. Rituximab may not only be effective, but it may also cause fewer adverse late effects.

A total of 13 patients with LPHD received rituximab at 375 mg/m2 weekly × 4. All tumors were CD20 positive and histologically and immunohistochemically consistent with LPHD. The median age was 39 years (range: 23 to 51 years), with nine males and five females. Eight patients had untreated disease, classified as stage IA (2 patients), IIA (2), or IIIA (4). Five patients had recurrent disease after radiation (2 patients), chemotherapy (2), and combined-modality treatment (1). Disease sites were neck (4), axilla (7), mediastinum (1), iliac (5), inguinal/femoral (2), and spleen (1). Restaging studies were performed at 6 weeks, 3 months, 6 months, and 12 months following therapy.

Of 9 evaluable patients, 6 had complete responses and 3 had partial responses (PR) at initial restaging. There has been one relapse at 6 months. This patient was subsequently retreated with rituximab at 375 mg/m2 weekly × 4, and has achieved a PR at 3-month follow-up. All 13 patients tolerated therapy well without grade 3 or 4 toxicities.

CONCLUSION: These preliminary results show that prompt tumor reduction with minimal toxicity can be achieved with rituximab in LPHD. Further follow-up and study is warranted to establish the durability of response and overall impact of this novel therapeutic approach.

Click here to read Dr. Bruce Cheson's commentary on this abstract.

 
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