Abstract
Ocular adnexal lymphomas (OALs) are typically low-grade lymphomas and are largely represented by marginal-zone lymphomas (EMZL). Radiotherapy is the treatment of choice but is frequently associated to local complications. We investigated the association of chlorambucil and rituximab as first-line treatment for primary OALs. Nine consecutive, newly diagnosed OALs patients (eight with a EMZL, one with a follicular lymphoma) with a median age of 78 years were treated with this combination. Eight patients were in stage I-A, and one was in stage IV-A; all patients had low LDH values. Eight patients (89%) obtained a complete remission and one a partial response. All completed the treatment without significant toxicities. After a median follow up of 25 months, all patients are alive; no progressions or late toxicities were observed. Rituximab in combination with chlorambucil proved to be a feasible option as first-line treatment for OALs because of its feasibility and the absence of toxicity and local sequelae.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Decaudin D, de Cremoux P, Vincent-Salomon A, Dendale R, Lumbroso-Le Rouic L (2006) Ocular adnexal lymphoma: a review of clinicopathologic features and treatment options. Blood 108:1451–1460
Meunier J, Lumbroso-Le Rouic L, Vincent-Salomon A, Dendale R, Asselain B, Arnaud P, Fourquet A, Desjardins L, Plancher C, Validire P, Chaoui D, Levy C, Decaudin D (2004) Ophthalmologic and intraocular non-Hodgkin’s lymphoma: a large single center study of initial characteristics, natural history, and prognostic factors. Hematol Oncol 22:143–158
Ferreri AJ, Ponzoni M, Guidoboni M, De Conciliis C, Resti AG, Mazzi B, Lettini AA, Demeter J, Dell’Oro S, Doglioni C, Villa E, Bogliocchi M, Dolcetti R (2005) Regression of ocular adnexal lymphoma after Chlamydia psittaci-eradicating antibiotic therapy. J Clin Oncol 23:5067–5073
Grunberger B, Hauff W, Lukas J, Wohrer S, Zielinski CC, Streubel B, Chott A, Raderer M (2006) ‘Blind’ antibiotic treatment targeting Chlamydia is not effective in patients with MALT lymphoma of the ocular adnexa. Ann Oncol 17:484–487
Bolek TW, Moyses HM, Marcus RB Jr, Gorden L 3rd, Maiese RL, Almasri NM, Mendenhall NP (1999) Radiotherapy in the management of orbital lymphoma. Int J Radiat Oncol Biol Phys 44:31–36
Bhatia S, Paulino AC, Buatti JM, Mayr NA, Wen BC (2002) Curative radiotherapy for primary orbital lymphoma. Int J Radiat Oncol Biol Phys 54:818–823
Cho EY, Han JJ, Ree HJ, Ko YH, Kang YK, Ahn HS, Ahn SD, Park CJ, Huh J (2003) Clinicopathologic analysis of ocular adnexal lymphomas: extranodal marginal zone B-cell lymphoma constitutes the vast majority of ocular lymphomas among Koreans and affects younger patients. Am J Hematol 73:87–96
Ben Simon GJ, Cheung N, McKelvie P, Fox R, McNab AA (2006) Oral chlorambucil for extranodal, marginal zone, B-cell lymphoma of mucosa-associated lymphoid tissue of the orbit. Ophthalmology 113:1209–1213
Conconi A, Martinelli G, Thieblemont C, Ferreri AJM, Devizzi L, Peccatori F, Ponzoni M, Pedrinis E, Dell’Oro S, Pruneri G, Filipazzi V, Dietrich PY, Gianni AM, Coiffier B, Cavalli F, Zucca E (2003) Clinical activity of rituximab in extranodal marginal zone B-cell lymphoma of MALT type. Blood 102:2741–2745
Raderer M, Jager G, Brugger S, Puspok A, Fiebiger W, Drach J, Wotherspoon A, Chott A (2003) Rituximab for treatment of advanced extranodal marginal zone B cell lymphoma of the mucosa-associated lymphoid tissue lymphoma. Oncology 65:306–310
Zinzani PL, Alinari L, Stefoni V, Loffredo A, Pichierri P, Polito E (2005) Rituximab in primary conjunctival lymphoma. Leuk Res 29:107–108
Benetatos L, Alymara V, Asproudis I, Bourantas KL (2006) Rituximab as first line treatment for MALT lymphoma of extraocular muscles. Ann Hematol 85:625–626
Ferreri AJM, Ponzoni M, Martinelli G, Muti G, Guidoboni M, Dolcetti R, Doglioni C (2005) Rituximab in patients with mucosal-associated lymphoid tissue-type lymphoma of the ocular adnexa. Haematologica 90:1578–1580
Sullivan TJ, Grimes D, Bunce I (2004) Monoclonal antibody treatment of orbital lymphoma. Ophthal Plast Reconstr Surg 20:103–106
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rigacci, L., Nassi, L., Puccioni, M. et al. Rituximab and chlorambucil as first-line treatment for low-grade ocular adnexal lymphomas. Ann Hematol 86, 565–568 (2007). https://doi.org/10.1007/s00277-007-0301-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00277-007-0301-y