Anti-CD20 monoclonal antibody therapy in relapsed MALT lymphoma of the conjunctiva

Low-grade non-Hodgkin's lymphomas of the conjunctiva may be cured by radiotherapy, but complications are frequent and relapses may occur. Other treatment modalities including resection, cryotherapy, injection of interferon-alpha or systemic chemotherapy have been used with varying success. We treated two patients with relapsed extranodal marginal zone lymphoma (ENMZL) of mucosa-associated lymphoid tissue (MALT) of the conjunctiva with the anti-CD20 monoclonal antibody rituximab (375 mg/m2 intravenously once weekly for 4 wk) which has previously been shown to be effective in a variety of other B-cell non-Hodgkin's lymphomas. Treatment was well tolerated and resulted in one partial and one complete remission. With a follow-up of 32 or 30 months, respectively, further recurrences have not been observed. Rituximab is a highly effective and well-tolerated treatment of conjunctival MALT lymphoma, which may not only be of value in relapse, but also in cases of contraindication to radiotherapy.