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Rituximab (Rituxan) in Lymphomas

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Updated December 17, 2006

What is Rituximab (Rituxan)?:

Rituximab (Rituxan) is a drug used in the treatment of Non-Hodgkin Lymphomas (NHL). It is one of a special group of drugs called ‘monoclonal antibodies’. Rituximab that attaches itself to a special molecule called CD20 that is present on the surface of B-cells. It is the B-cells that become cancerous in many lymphomas. By attaching to this molecule, Rituximab inactivates the cancer cells and eliminates them. As it binds only to a very specific molecule present on B-cells only, Rituximab produces no ill effects on normal cells in the body.

Rituximab in Low grade (Follicular) NHL:

Rituximab is used in multiple settings in low grade NHL:

  • For those who have been treated with chemotherapy before but have relapsed, Rituximab can be used as a salvage treatment.
  • For those who have had no treatment yet, Rituximab can be used along with chemotherapy.
  • For those who have just completed chemotherapy and shown a response, Rituximab also helps as a maintenance treatment. It delays progression significantly, compared to no further treatment.

Rituximab in Diffuse Large B-cell Lymphoma:

Rituximab is now considered a standard part of initial treatment when used with chemotherapy combinations like CHOP. Three large studies have demonstrated that not only does adding Rituximab delay disease relapse or progression, it may also result in improved survival. Rituximab is therefore given with each cycle of chemotherapy, and may be continued for a period beyond completion of chemotherapy cycles. For those who have been treated earlier with chemotherapy alone and have now relapsed or progressed, Rituximab may be administered as a salvage treatment.

How is Rituximab given?:

Rituximab is administered as an infusion in your veins. Rituximab is given over a few hours. The infusion is started slowly, and if the patient does not show any reactions to the medicine, the rate of infusion is increased every hour till the infusion is over.

Rituximab is administered on a weekly basis for 4-8 weeks when it is administered alone. When administered along with chemotherapy, it is usually given on the first day of each cycle of chemotherapy for each of the 6-8 cycles.

What are the side effects with Rituximab?:

  • The main side effects of Rituximab are related to infusion reactions. The majority of patients have some kind of a reaction, more so during the first infusion. The commonest symptoms are fever and chills, with some patients feeling itchy or lightheaded. These are easily controlled by trained staff, and are rarely worrisome.
  • Rituximab may result in a fall in blood counts, like chemotherapy. This may occasionally result in fever, and may require growth factor injections for control.
  • A small number of patients may have some cough and nasal discharge following Rituximab. Serious lung complications are very rare.

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