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Critical appraisal of rituximab in the maintenance treatment of advanced follicular lymphoma

Authors Aguiar-Bujanda D, Blanco-Sánchez MJ, Hernández-Sosa M, Galván-Ruíz S, Hernández-Sarmiento S

Received 16 July 2015

Accepted for publication 23 September 2015

Published 27 October 2015 Volume 2015:7 Pages 319—330

DOI https://doi.org/10.2147/CMAR.S69145

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Ujjawal Gandhi

Peer reviewer comments 3

Editor who approved publication: Professor Kenan Onel

David Aguiar-Bujanda, María Jesús Blanco-Sánchez, María Hernández-Sosa, Saray Galván-Ruíz, Samuel Hernández-Sarmiento

Department of Medical Oncology, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain

Abstract: Rituximab is an IgG1, chimeric monoclonal antibody specifically designed to recognize the CD20 antigen expressed on the surface of normal and malignant B-lymphocytes, from the B-cell precursor to the mature B-cells of the germinal center, and by most neoplasms derived from B-cells. After 2 decades of use, rituximab is firmly positioned in the treatment of follicular lymphoma (FL), both in the front line and in the relapsing disease, improving previous results by including it in classical chemotherapy regimens. However, the pharmacology of rituximab continues to generate controversial issues especially regarding the mechanisms of action in vivo. The contribution of rituximab as a maintenance treatment in FL has been significant progress in the management of this disease without an increase in side effects or a decrease in the quality of life of patients. With the widespread use of rituximab, there are new security alerts and side effects not previously detected in the pivotal trials that clinicians should learn to recognize and manage. In this article, we will review the pharmacokinetics and pharmacodynamics of rituximab, the management issues in the treatment of advanced FL focusing on maintenance rituximab, its long-term efficacy and safety profile, and its effect on the quality of life.

Keywords: follicular lymphoma, long-term efficacy, maintenance, rituximab, toxicity

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