4th Palermo Conference on INNOVATIVE THERAPIES FOR LYMPHOID MALIGNANCIES
Published online 13 August 2009
Haematologica, Vol 95, Issue 2, 329-332 doi:10.3324/haematol.2009.012484
Copyright © 2010 by Ferrata Storti Foundation
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Chronic Lymphocytic Leukemia

Fractionated subcutaneous rituximab is well-tolerated and preserves CD20 expression on tumor cells in patients with chronic lymphocytic leukemia

Georg Aue1, Margaret A. Lindorfer2, Paul V. Beum2, Andrew W. Pawluczkowycz2, Berengere Vire1, Thomas Hughes3, Ronald P. Taylor2, Adrian Wiestner1

1 Hematology Branch, NHLBI, of the National Institutes of Health, Bethesda, MD
2 Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, VA
3 Department of Pharmacy, Clinical Center, of the National Institutes of Health, Bethesda, MD, USA

Correspondence: Adrian Wiestner MD, PhD, Hematology Branch, NHLBI, NIH Bldg. 10, CRC 3-5140, 10 Center Drive, Bethesda, MD 20892-1202 USA. E-mail: wiestnera{at}mail.nih.gov / Ronald P. Taylor, PhD, Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, VA, USA. E-mail: rpt{at}virginia.edu

A pilot study previously demonstrated that thrice-weekly, fractionated-dose intravenous rituximab (RTX) limits CD20 loss from chronic lymphocytic leukemia (CLL) B cells, thereby enhancing immunotherapeutic targeting. Here, we investigated the feasibility of giving 20 mg rituximab subcutaneously thrice weekly for up to 12 weeks in 4 previously treated CLL patients. Subcutaneous rituximab was well-tolerated with minimal injection site reactions; a variable degree of efficacy was observed, likely influenced by the size of the patients’ B cell/CD20 burden. Subcutaneous RTX largely preserved CD20 expression on leukemic cells but the most effective therapeutic dosing regimen needs to be established (ClinicalTrials.gov Identifier: NCT00366418).

Key words: rituximab, subcutaneous, CD20 shaving, antigenic modulation, chronic lymphocytic leukemia.