Inclusion of Rituximab in Treatment Protocols for Non-Hodgkin's Lymphomas and Risk for Progressive Multifocal Leukoencephalopathy
Open Access
- 1 November 2010
- journal article
- Published by Oxford University Press (OUP) in The Oncologist
- Vol. 15 (11), 1214-1219
- https://doi.org/10.1634/theoncologist.2010-0098
Abstract
Objectives. Rituximab is an anti-CD20 monoclonal antibody that promotes better treatment outcomes in patients with non-Hodgkin's lymphoma (NHL). Case series of progressive multifocal leukoencephalopathy (PML) in patients receiving rituximab within polychemotherapy regimens have led to the introduction of a black box warning, but no risk estimation has ever been provided. Methods. We performed a retrospective, monocentric cohort study on 976 NHL patients diagnosed in 1994–2008, including 517 patients who received at least one dose of rituximab. Results. Inclusion of rituximab into standard chemotherapy regimens for NHL caused a significantly higher incidence of PML cases (rate difference, 2.2 every 1,000 patient-years; 95% confidence interval, 0.1–4.3). Interpretation. Based on this finding, clinical surveillance of PML-related symptoms is recommended in NHL patients exposed to rituximab.Keywords
This publication has 17 references indexed in Scilit:
- Re: Rituximab maintenance for the treatment of patients with follicular lymphoma: systematic review and meta-analysis of randomized trials.JNCI Journal of the National Cancer Institute, 2009
- Reemergence of PML in Natalizumab-Treated Patients — New Cases, Same ConcernsThe New England Journal of Medicine, 2009
- Targeted but not trouble-free: efalizumab and PMLNature Reviews Rheumatology, 2009
- Progressive multifocal leukoencephalopathy after rituximab therapy in HIV-negative patients: a report of 57 cases from the Research on Adverse Drug Events and Reports projectBlood, 2009
- Ten years of rituximab in NHLExpert Opinion on Drug Safety, 2009
- Rituximab Maintenance for the Treatment of Patients With Follicular Lymphoma: Systematic Review and Meta-analysis of Randomized TrialsJNCI Journal of the National Cancer Institute, 2009
- Major congenital malformations following prenatal exposure to serotonin reuptake inhibitors and benzodiazepines using population‐based health dataBirth Defects Research Part B: Developmental and Reproductive Toxicology, 2008
- A New Approach to Integrating Data From Multiple Informants in Psychiatric Assessment and Research: Mixing and Matching Contexts and PerspectivesAmerican Journal of Psychiatry, 2003
- The Evolving Face of Human Immunodeficiency Virus-Related Progressive Multifocal Leukoencephalopathy: Defining a Consensus TerminologyJournal of NeuroVirology, 2003
- When can odds ratios mislead?BMJ, 1998