RESEARCH - Remission of Sjogren's syndrome associated lymphomas following combined B cell depletion and CHOP

[Guest guest]

Ann Rheum Dis. 2006 Aug;65(8):1033-7. Epub 2005 Dec 1.

Long term remission of Sjogren's syndrome associated aggressive B cell

non-Hodgkin's lymphomas following combined B cell depletion therapy and CHOP

(cyclophosphamide, doxorubicin, vincristine, prednisone).

Voulgarelis M, Giannouli S, Tzioufas AG, Moutsopoulos HM.

Department of Pathophysiology, Medical School, National University of

Athens, M Asias 75, Goudi 11527 Athens, Greece. hmoutsop@...

BACKGROUND: Primary Sjogren's syndrome (SS) is associated with an increased

frequency of non-Hodgkin's lymphomas (NHLs), mainly of low histological

grade. However, aggressive diffuse large B cell lymphomas (DLBCL)

characterised by poor treatment outcome can also be encountered in SS. It

has recently been shown that rituxan has significant therapeutic activity in

this type of lymphoma. OBJECTIVE: To evaluate the efficacy of CHOP

chemotherapy (cyclophosphamide, doxorubicin, vincristine, prednisone) in

combination with rituxan in SS patients with DLBCL, and to determine the

outcome in such patients. METHODS: In an open, single case trial, six SS

patients with DLBCL were assigned to receive eight cycles of CHOP every

three weeks plus rituxan given on day 1 of each cycle. In a retrospective

study, conducted by the European Concerted Action for SS, nine cases were

diagnosed as DLBCL, all of whom had been treated with CHOP alone. These

patients were used as historical controls. RESULTS: The difference in the

overall survival between the two treatment groups was significant. The group

treated with rituxan plus CHOP had a 100% two year overall survival rate,

while the historical controls had only a 37% survival rate. Extraglandular

manifestations serving as predictors for lymphoma development such as

palpable purpura and peripheral neuropathy disappeared. The remission of

these signs was accompanied by a decrease in both circulating monoclonal

cryoglobulins and rheumatoid factor activity and an increase in C4 levels.

Clinically relevant toxicity was not detected.

CONCLUSIONS: The addition of rituxan to standard CHOP chemotherapy results

in improved treatment outcome in SS patients with aggressive DLBCL, without

increasing toxicity.

PMID: 16322082

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6322082

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org