Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2010 Feb;95(2):329-32.
doi: 10.3324/haematol.2009.012484. Epub 2009 Aug 13.

Fractionated subcutaneous rituximab is well-tolerated and preserves CD20 expression on tumor cells in patients with chronic lymphocytic leukemia

Georg Aue  1 , Margaret A Lindorfer, Paul V Beum, Andrew W Pawluczkowycz, Berengere Vire, Thomas Hughes, Ronald P Taylor, Adrian Wiestner
Affiliations
Clinical Trial

Fractionated subcutaneous rituximab is well-tolerated and preserves CD20 expression on tumor cells in patients with chronic lymphocytic leukemia

Georg Aue et al. Haematologica. 2010 Feb.

Abstract

A pilot study previously demonstrated that thrice-weekly, fractionated-dose intravenous rituximab (RTX) limits CD20 loss from chronic lymphocytic leukemia (CLL) B cells, thereby enhancing immunotherapeutic targeting. Here, we investigated the feasibility of giving 20 mg rituximab subcutaneously thrice weekly for up to 12 weeks in 4 previously treated CLL patients. Subcutaneous rituximab was well-tolerated with minimal injection site reactions; a variable degree of efficacy was observed, likely influenced by the size of the patients' B cell/CD20 burden. Subcutaneous RTX largely preserved CD20 expression on leukemic cells but the most effective therapeutic dosing regimen needs to be established (ClinicalTrials.gov Identifier: NCT00366418).

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Absolute lymphocyte counts, CD20 expression and complement deposition on leukemic cells during the first 72 hours of treatment in chronic lymphocytic leukemia. The first 20 mg intravenous dose of RTX on day 1 was followed by a subcutaneous 20 mg dose of RTX on day 3. (A) Absolute lymphocyte counts (ALC) pre-treatment, and 2, 4, 6, 24 hours after the first 20 mg intravenous infusion of RTX. The dashed line at the 48 hour timepoint indicates the first subcutaneous injection of 20 mg RTX. Measurements are taken 2, 4, 6, and 24 hours after the subcutaneous RTX administration. (B) Quantitative levels of CD20 on patient’s B cells by flow cytometry (molecules of equivalent soluble fluorochome, MESF). (C) Cells were stained with an mAb specific for C3dg to measure deposition of complement fragments on cells after RTX treatment.
Figure 2.
Figure 2.
A single 20 mg intravenous dose of RTX on day 1 followed by thrice weekly subcutaneous 20 mg doses of RTX over 6–12 weeks. (A) ALC, and (B) quantitative levels of CD20 on patient’s B cells are shown for the period of treatment. The last RTX injection for patient 1 was on day 84, and final measurements on day 92 are shown.
See this image and copyright information in PMC

References

    1. Maloney DG, Grillo-López AJ, White CA, Bodkin D, Schilder RJ, Neidhart JA, et al. IDEC-C2B8 (Rituximab) anti-CD20 monoclonal antibody therapy in patients with relapsed low-grade non-Hodgkin’s lymphoma. Blood. 1997;90(6):2188–95. - PubMed
    1. McLaughlin P, Grillo-Lopez AJ, Link BK, Levy R, Czuczman MS, Williams ME, et al. Rituximab chimeric anti-CD20 monoclonal antibody therapy for relapsed indolent lymphoma: half of patients respond to a four-dose treatment program. J Clin Oncol. 1998;16(8):2825–33. - PubMed
    1. Huhn D, von Schilling C, Wilhelm M, Ho A, Hallek M, Kuse R, et al. Rituximab therapy of patients with B-cell chronic lymphocytic leukemia. Blood. 2001;98(5):1326–31. - PubMed
    1. Kennedy AD, Beum PV, Solga MD, DiLillo DJ, Lindorfer MA, Hess CE, et al. Rituximab infusion promotes rapid complement depletion and acute CD20 loss in chronic lymphocytic leukemia. J Immunol. 2004;172(5):3280–8. - PubMed
    1. Taylor RP, Lindorfer MA. Immunotherapeutic mechanisms of anti-CD20 monoclonal antibodies. Curr Opin Immunol. 2008;20(4):444–9. - PMC - PubMed

Publication types

MeSH terms

Associated data