Rituximab in indolent lymphomas

Indolent non-Hodgkin lymphoma (NHL) comprises a group of incurable, generally slow-growing lymphomas highly responsive to initial therapy, with a relapsing and progressive course. Rituximab, an anti-CD20 antibody, has had a large impact on the treatment of indolent NHL. Its effectiveness as a single agent and in conjunction with known chemotherapy regimens has made it a standard of care in the treatment of NHL. Analysis of data obtained from NHL clinical trials, as well as data from the National Cancer Institute, indicate that the overall survival (OS) of patients with indolent NHL has improved since the discovery of rituximab. Given its effectiveness and tolerability, rituximab is currently being investigated as a maintenance agent with encouraging results. This review summarizes several landmark trials utilizing rituximab as a single agent and in combination with chemotherapy for treatment of NHL. In addition, a review of the studied rituximab maintenance dosing schedules and its impact on NHL will be presented. Overall, rituximab has changed the landscape for treatment of indolent NHL; however, additional research is necessary to identify the optimal dosing schedule, as well as patients most likely to respond to prolonged rituximab therapy.