Abstract
Purpose
We recently reported on the efficacy of intralesional rituximab for treating primary ocular adnexal lymphoma in a pilot study. After treatment, a complete response was observed in two of five patients, a partial response in one patient, and lesion recurrence in two patients. In this study, we evaluate the long-term follow-up of the five previously treated patients as well as the response of two new patients to an augmented dose of rituximab.
Methods
We followed up the five patients who were treated with rituximab during the initial pilot study. Two additional patients were also enrolled and treated with four intraorbital injections of 10 mg rituximab once a week for 1 month (total dose of 40 mg). Median follow-up period was 4 years for the first five patients and 1 year for the last two patients.
Results
Lymphoma did not relapse in the two patients who originally responded immediately to treatment. Of the initial partial responders, one became disease-free after additional rituximab treatment, and one experienced a standardized uptake value reduction, as measured with positron emission tomography–CT. One patient who experienced abdominal and pulmonary localization 7 months later showed no local recurrence. The two newly enrolled patients had complete remission after the first cycle of treatment and no disease recurrence eight and 11 months later, respectively.
Conclusions
This study suggests that intralesional administration of rituximab for treating localized ocular adnexal CD20+ lymphomas could be an effective front-line therapeutic option with negligible side effects and a good response rate and duration.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Coupland SE, Hummel M, Stein H (2002) Ocular adenexal lymphomas: five case presentations and a review of the literature. Surv Ophthalmol 47:470–490
Coupland SE, White VA, Rootman J, Damato B, Finger PT (2009) A TNM-based clinical staging system of ocular adnexal lymphomas. Arch Pathol Lab Med 133(8):1262–1267
Decaudin D, Ferroni A, Vincent-Salomon A et al (2010) Ocular adnexal lymphoma and Helicobacter pylori gastric infection. Am J Hematol 85:645–649
Ferreri AJ, Govi S, Colucci A, Crocchiolo R, Modorati G (2011) Intralesional rituximab a new therapeutic approach for patients with conjunctival lymphomas. Ophthalmology 118:24–28
Habermann TM, Weller EA, Morrison VA et al (2002) Rituximab in combination with CHOP improves survival in elderly patients with aggressive non-Hodgkin’s lymphoma. Semin Oncol 29:18–22
Habermann TM, Weller EA, Morrison VA et al (2006) Rituximab CHOP versus CHOP alone or with maintenance rituximab in older patients with diffuse large B-cell lymphoma. J Clin Oncol 24:3121–3127
Kaushik M, Pulido JS, Schild SE, Stafford S (2012) Risk of radiation retinopathy in patients with orbital and ocular lymphoma. J Radiat Oncol Biol Phys 84:1145–1150
Kimbly E (2005) Tolerability and safety of rituximab (Mabthera). Cancer Treat Rev 31:456–473
Lanini S, Molloy AC, Fine PE, Prentice AG, Ippolito G, Kibbler CC (2011) Risk of infection in patients with lymphoma receiving rituximab: systematic review and meta-analysis. BMC Med 9:36
Laurenti L, De Padua L, Battendieri R et al (2011) Intralesional administration of rituximab for treatment of CD20 positive orbital lymphoma: safety and efficacy evaluation. Leuk Res 35:682–684
Maloney DG, Grillo-López AJ, Bodkin DJ et al (1997) IDEC-C2B8 (Rituximab) anti CD20+ monoclonal antibody therapy in patients with relapsed low-grade non Hodgkin’s lymphoma. Blood 90:2188–2195
Padhi S, Paul TR, Challa S et al (2012) Primary extra nodal non-Hodgkin lymphoma: a 5 year retrospective analysis. J Cancer Prev 13:4889–4895
Paik JS, Cho WK, Lee SE (2012) Ophthalmologic outcomes after chemotherapy and/or radiotherapy in non-conjunctival ocular adnexal MALT lymphoma. Hematol 91:1393–1401
Peñate Y, Hernández-Machín B, Pérez-Méndez LI, Santiago F, Rosales B, Servitje O et al (2012) Intralesional rituximab in the treatment of indolent primary cutaneous B-cell lymphomas: an epidemiological observational multicentre study. The Spanish Working Group on Cutaneous Lymphoma. Br J Dermatol 167(1):174–179
Roguedas AM, Watier H, Paintaud G, de Muret A, Vaillant L, Machet L (2005) Intralesional therapy with anti CD20+ monoclonal antibody rituximab: local and systemic efficacy in primary cutaneous B-cell lymphoma. Br J Dermatol 152:541–544
Savino G, Battendieri R, Balia L et al (2011) Evaluation of intraorbital injection of rituximab for treatment of primary ocular adnexal lymphoma: a pilot study. Cancer Sci 102:1565–1567
Solal-Céligny P, Roy P, Colombat P et al (2004) Follicular lymphoma international prognostic index. Blood 104:1258–1265
Stefanovic A, Lossos IS (2009) Extranodal marginal zone lymphoma of the ocular adnexa. Blood 114:501–510
Tobinai K, Kobayashi Y, Narabayashi M et al (1998) Feasibility and pharmacokinetic study of a chimeric anti-CD20 monoclonal antibody (IDECC2B8, rituximab) in relapsed B-cell lymphoma. The IDEC-C2B8 Study Group. Ann Oncol 9:527–534
Uno T, Isobe K, Shikama N et al (2003) Radiotherapy for extranodal, marginal zone, B-cell lymphoma of mucosa-associated lymphoid tissue originating in the ocular adnexa: a multiinstitutional, retrospective review of 50 patients. Cancer 98:865–871
Witzig TE, Vukov AM, Habermann TM et al (2005) Rituximab therapy for patients with newly diagnosed, advanced-stage, follicular grade I non-Hodgkin’s lymphoma: a phase II trial in the North Central Cancer Treatment Group. J Clin Oncol 23:1103–1108
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Savino, G., Battendieri, R., Gari, M. et al. Long-term outcomes of primary ocular adnexal lymphoma treatment with intraorbital rituximab injections. J Cancer Res Clin Oncol 139, 1251–1255 (2013). https://doi.org/10.1007/s00432-013-1438-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00432-013-1438-9