Monoclonal Antibody Therapy: Rituxan

Rituxan targets B-cells (Roche)

Rituxan (generic: rituximab) is a monoclonal antibody used in the treatment of indolent and follicular B-cell Non-Hodgkin’s Lymphomas (NHL). It is administered to patients via IV drip.

Rituxan works by attaching to the CD20 antigen–a type of cell "marker"–found on B-cells. This signals the body’s immune system to activate. Specialized "killer cells" like macrophages then attack and remove the marked cells, thus removing the tumors.

The monoclonal antibody can be used alone or in combination with other drugs. For patients with diffuse large B-cell lymphomas, Rituxan is commonly administered with the CHOP chemotherapy regimen. For patients with follicular lymphomas, it is often used in combination with the CVP chemotherapy regimen.

In cases where cancer cells are resistant to Rituxan treatment, it may be used in conjunction with Zevalin. Zevalin also attaches to the CD20 antigen, but it emits a small amount of radiation, thus killing the affected B-cells.

Side Effects

Patients may have adverse or severe reactions from Rituxan. For this reason, they should be closely monitored during drug administration, especially during the first dose. Also, live virus vaccinations should not be administered while a patient is being treated with Rituxan.

The most common side effects are infusion reactions, like fever, chills, and fatigue. Infection can also occur as a result of lymphopenia (the depletion of B-cells), which weakens the immune system. Some patients may suffer from more severe reactions than others.

Less common, but more severe symptoms include

• Bowel Obstruction and Perforation: Minor to severe discomfort may be experienced after the administration of Rituxan. Patients should inform their doctor if this occurs.
• Arrhythmias: Minor to severe heart problems can arise from the use of Rituxan.
• Hepatitis B Reactivation: A patient previously infected with Hepatitis B may suffer from reactivation of the disease. This can lead to liver failure if left untreated.
• Tumor Lysis Syndrome: This phenomenon occurs when cancerous cells are broken down, releasing harmful toxins into the blood. Renal damage or failure can occur when the kidneys try to filter out those toxins.
• Severe Mucocutaneous Reactions: These skin reactions usually occur near the body’s orifices, like the lips. Reactions vary by patient, and can involve a minor skin lesion or more severe eruption.
• Progressive Multifocal Leukoencephalopathy (PML): This rare and extremely severe disease is causes by the JC virus. It affects the brain and can prove fatal.
• Symptoms can usually be reversed if treated early. Talk to your doctor immediately if you suffer from any symptoms while on Rituxan treatments.

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