Title | The absence of CD20 messenger RNA in recurrent cutaneous B-cell lymphoma following rituximab therapy. |
Publication Type | Journal Article |
Year of Publication | 2005 |
Authors | Rawal YB, Nuovo GJ, Frambach GE, Porcu P, Baiocchi RA, Magro CM |
Journal | J Cutan Pathol |
Volume | 32 |
Issue | 9 |
Pagination | 616-21 |
Date Published | 2005 Oct |
ISSN | 0303-6987 |
Keywords | Adult, Aged, Aged, 80 and over, Antibodies, Monoclonal, Antibodies, Monoclonal, Murine-Derived, Antigens, CD20, Antineoplastic Agents, Biomarkers, Tumor, Female, Humans, Immunohistochemistry, Lymphoma, B-Cell, Male, Middle Aged, Neoplasm Recurrence, Local, Reverse Transcriptase Polymerase Chain Reaction, Rituximab, RNA, Messenger, Skin Neoplasms |
Abstract | BACKGROUND: Rituximab has been used to treat relapsed low-grade or advanced non-Hodgkin's lymphoma since 1997, targeting the CD20 antigen expressed by B cells. Single-agent rituximab therapy is safe and well tolerated. Recurrences showing a loss of CD20 expression following rituximab therapy have been reported. METHODS: Four patients with CD20-positive cutaneous B-cell lymphoma received rituximab therapy with subsequent recurrences. The biopsies were assessed for cytoplasmic CD20 expression; CD20 messenger RNA was also assessed where tissue was available. RESULTS: Cutaneous relapses occurring within 1.5-3 months following the last dose of rituximab were CD20 negative. In three cases, subsequent relapses showed renewed expression of CD20. Those biopsies demonstrating a loss of surface and cytoplasmic CD20 by immunohistochemistry also showed no evidence of messenger RNA for CD20 using an in situ polymerase chain reaction-based methodology. CONCLUSIONS: Rituximab may be associated with the emergence of CD20-negative B-cell clones, potentially rendering a tumor insensitive to this drug. Conversely, following cessation of the drug, a re-expression of CD20 within the neoplastic cells may occur allowing therapeutic intervention with this monoclonal antibody. The loss of CD20 expression appears to be a direct effect of the drug on CD20 messenger RNA synthesis. |
DOI | 10.1111/j.0303-6987.2005.00305.x |
Alternate Journal | J Cutan Pathol |
PubMed ID | 16176299 |
Related Faculty:
Cynthia M. Magro, M.D.