PCR Analysis for the t(14;18) Translocation in Patients With Recurrent Follicular Lymphoma Following Immunotherapy With Rituximab (IDEC-C2B8)

OncologyONCOLOGY Vol 13 No 3
Volume 13
Issue 3

The chimeric monoclonal anti-CD20 antibody rituximab (Rituxan) has been shown to have clinical activity in patients with


The chimeric monoclonal anti-CD20 antibody rituximab (Rituxan) has been shown to have clinical activity in patients with follicular lymphoma. It depletes normal and malignant B-cells, binds complement, and effects complement-dependent cytotoxicity and antibody-dependent cytotoxicity. In patients with recurrent disease, the overall response rate (complete response [CR] + partial response [PR]) is 40% to 50%.

The t(14;18) chromosomal translocation can be detected in the diagnostic material of up to 80% of patients with follicular lymphoma using polymerase chain reaction (PCR) assays. This has subsequently been used as a surrogate marker, particularly in the setting of minimal residual disease.

A multicenter trial to confirm the reported efficacy of rituximab in the therapy of follicular lymphoma has been undertaken in the United Kingdom. Seventy previously treated adults were enrolled; the clinical response rate for the 67 evaluable patients was 48% (1 CR and 31 PRs).

A parallel study was undertaken at St. Bartholomew’s Hospital to monitor minimal residual disease using a two-step nested PCR for t(14;18). Material, including lymph node biopsies, diagnostic bone marrow, and peripheral blood samples, was obtained from 58 patients. Of these 58 patients, 31 (53%) were PCR-positive either in lymph node (13), and/or bone marrow (12), and/or blood (20) prior to rituximab therapy.

Follow-up bone marrow and blood samples (obtained a month after the last infusion) were available in 28 of these patients. Overall, 17/28 (61%) became PCR-negative. Of the patients who had a PR, 10/15 (67%) were PCR-negative after therapy, while 7/13 (54%) nonresponders (stable or progressive disease) became PCR-negative. Conversely, 5/11 (45%) patients who remained PCR-positive had a PR.

CONCLUSION: This study suggests that rituximab is very effective in decreasing (or eliminating) the number of CD20-positive cells (including follicular lymphoma cells) in bone marrow and/or peripheral blood, irrespective of the clinical response. Therefore, although obtaining a PCR-negative state does not reflect the clinical outcome, such immunotherapy may be extremely useful as a means of in vivo purging prior to the harvesting of progenitor cells to support high-dose therapy in such patients with follicular lymphoma.

Click here for Dr. Bruce Cheson’s commentary on this abstract.

Articles in this issue

WHO Declares Lymphatic Mapping to Be the Standard of Care for Melanoma
Rituximab: Phase II Retreatment Study in Patients With Low-Grade or Follicular Non-Hodgkin’s Lymphoma
Response Criteria for NHL: Importance of “Normal” Lymph Node Size and Correlations With Response
Chemotherapy Plus Radiation Improves Survival in Patients With Cervical Cancer
A Randomized Trial of Fludarabine, Mitoxantrone (FM) Versus Doxorubicin, Cyclophosphamide, Vindesine, Prednisone (CHEP) as First Line Treatment in Patients With Advanced Low-Grade Non-Hodgkin's Lymphoma: A Multicenter Study by GOELAMS Group
Navelbine Increased Elderly Lung Cancer Patients’ Survival
Fludarabine Versus Conventional CVP Chemotherapy in Newly C Diagnosed Patients With Stages III and IV Low-Grade Malignant Non-Hodgkin’s Lymphoma: Preliminary Results From a Prospective, Randomized Phase III Clinical Trial in 381 Patients
Multicenter, Phase III Study of Iodine-131 Tositumomab (Anti-B1 Antibody) for Chemotherapy-Refractory Low-Grade or Transformed Low-Grade Non-Hodgkin’s Lymphoma
T-Cell–Depleted Allogeneic Bone Marrow Transplant From HLA-Matched Sibling Donors for Non-Hodgkin’s Lymphoma
Consensus Statement on Prevention and Early Diagnosis of Lung Cancer
In Vivo Purging and Adjuvant Immunotherapy With Rituximab During PBSC Transplant For NHL
Fludarabine and Cyclophosphamide: A Highly Active and Well-Tolerated Regimen for Patients With Previously Untreated Indolent Lymphomas
Campath-1H Monoclonal Antibody in Therapy for Advanced Low-Grade Non-Hodgkin’s Lymphomas: A Phase II Study
AIDS Drugs Effective Against Most Common HIV Strain
Rituximab Therapy in Previously Treated Waldenström’s Macroglobulinemia: Preliminary Evidence of Activity
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