Impact of Rituximab (Rituxan) on the Treatment of B-Cell Non-Hodgkin's Lymphoma

Abstract

Non-Hodgkin's lymphoma (NHL) is the most common hematological malignancy in adults, with B-cell lymphomas accounting for 85% of all NHLs. The most substantial advancement in the treatment of B-cell malignancies, since the advent of combination chemotherapy, has been the addition of the monoclonal anti-CD20 antibody rituximab (Rituxan). Since its initially reported single-agent activity in indolent lymphomas in 1997, the role of rituximab has expanded to cover both indolent and aggressive lymphomas.This article focuses on the impact of rituximab on the treatment, survival, and long-term outcomes of patients with indolent and aggressive lymphomas over the past two decades.

Keywords: non-Hodgkin’s lymphoma; rituximab.

Figure 1

Overall survival according to treatment regimen in diffuse large B-cell lymphoma. Results of a randomized trial of non-rituximab containing regimens as historical controls for British Columbia outcome data with R-CHOP. MACOP-B = methotrexate, Adriamycin, cyclophosphamide (Cytoxan), Oncovin, prednisone–bleomycin; m-BACOD = methotrexate–bleomycin, Adriamycin, cyclophosphamide, Oncovin, dexamethasone; ProMACE–Cyta BOM = prednisone, methotexate, Adriamycin, cyclophosphamide, etoposide/cytarabine, bleomycin, Oncovin, methotrexate; R-CHOP = rituximab–cyclophosphamide, hydroxydaunorubicin (doxorubicin), Oncovin (vincristine), prednisone. (From Sehn LH, et al. J Clin Oncol 2005;23:5027–5033. © 2008 American Society of Clinical Oncology; and Fisher RI, et al. N Engl J Med 1993;328:1002–1006. © 1993 Massachusetts Medical Society.43)