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. 2010;15(11):1214-9.
doi: 10.1634/theoncologist.2010-0098. Epub 2010 Nov 1.

Inclusion of rituximab in treatment protocols for non-Hodgkin's lymphomas and risk for progressive multifocal leukoencephalopathy

Marco Tuccori  1 , Daniele Focosi, Corrado Blandizzi, Matteo Pelosini, Sabrina Montagnani, Fabrizio Maggi, Mauro Pistello, Luca Antonioli, Matteo Fornai, Pasquale Pepe, Giuseppe Rossi, Mario Petrini
Affiliations

Inclusion of rituximab in treatment protocols for non-Hodgkin's lymphomas and risk for progressive multifocal leukoencephalopathy

Marco Tuccori et al. Oncologist. 2010.

Abstract

Objectives. Rituximab is an anti-CD20 monoclonal antibody that promotes better treatment outcomes in patients with non-Hodgkin's lymphoma (NHL). Case series of progressive multifocal leukoencephalopathy (PML) in patients receiving rituximab within polychemotherapy regimens have led to the introduction of a black box warning, but no risk estimation has ever been provided. Methods. We performed a retrospective, monocentric cohort study on 976 NHL patients diagnosed in 1994-2008, including 517 patients who received at least one dose of rituximab. Results. Inclusion of rituximab into standard chemotherapy regimens for NHL caused a significantly higher incidence of PML cases (rate difference, 2.2 every 1,000 patient-years; 95% confidence interval, 0.1-4.3). Interpretation. Based on this finding, clinical surveillance of PML-related symptoms is recommended in NHL patients exposed to rituximab.

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Conflict of interest statement

Disclosures

Marco Tuccori: None; Daniele Focosi: None; Corrado Blandizzi: None; Matteo Pelosini: None; Sabrina Montagnani: None; Fabrizio Maggi: None; Mauro Pistello: None; Luca Antonioli: None; Matteo Fornai: None; Pasquale Pepe: None; Giuseppe Rossi: None; Mario Petrini: None.

Section Editor George Canellos discloses that he serves as a consultant for the Celgene Business Advisory Board.

Reviewer “A” discloses no financial relationships.

Reviewer “B” discloses no financial relationships.

Reviewer “C” serves on a speakers bureau for Genentech.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. On the basis of disclosed information, all conflicts of interest have been resolved.

Figures

Figure 1.
Figure 1.
Distribution of patients by year of first diagnosis of non-Hodgkin's lymphoma.
Figure 2.
Figure 2.
Percentage of patients receiving neurologic-oriented procedures (computed tomography scan, magnetic resonance imaging, neurologic consultations) per year (p = .534). (Data recorded up to April 2008.)
See this image and copyright information in PMC

References

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