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High efficacy of Rituximab in indolent HCV-related lymphoproliferative disorders associated with systemic autoimmune
G Cervetti1, S Mechelli, R Riccioni
1Department of Oncology, Transplants and Advances in Medicine, Section of Hematology, University of Pisa, Pisa, Italy.
Objective:
The evidence of an increased frequency of B-non Hodgkin's lymphomas (NHL) in patients with HCV and systemic autoimmune diseases suggests a close relationship between infection, autoimmunity and cancer. Choosing the best therapy for patients affected either by HCV-related lymphoma or autoimmune disorders is not easy; in fact, some treatments may be accompanied by an excessive hepatic toxicity and may be followed by a reactivation of hepatitis. There is growing interest in the search for an ideal therapy for this kind of patient. Thanks to its mechanism of action and good toxicity profile, Rituximab could prove to be an attractive therapeutic option: it has been reported to be highly active in low-grade NHLs and has been proposed for the management of autoimmune diseases.
Results:
In this paper we evaluate the role of anti-CD20 monoclonal antibody in mono-therapy in 10 patients with either indolent HCV-related lymphoma or autoimmune disease. A very high rate of response, of both NHL and of the associated autoimmune disease, was observed (100% of clinical response), with no significant hepatic and extra-hepatic toxicity.
Conclusion:
Thus, although the number of patients was small, our data strongly support the use of anti-CD20 in this patient setting.