Targeting intratumoral B cells with rituximab in addition to CHOP in angioimmunoblastic T-cell lymphoma. A clinicobiological study of the GELA.

Détails

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Etat: Public
Version: Final published version
ID Serval
serval:BIB_9B330C80E235
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Targeting intratumoral B cells with rituximab in addition to CHOP in angioimmunoblastic T-cell lymphoma. A clinicobiological study of the GELA.
Périodique
Haematologica
Auteur(s)
Delfau-Larue M.H., de Leval L., Joly B., Plonquet A., Challine D., Parrens M., Delmer A., Salles G., Morschhauser F., Delarue R., Brice P., Bouabdallah R., Casasnovas O., Tilly H., Gaulard P., Haioun C.
ISSN
0390-6078
ISSN-L
1592-8721
Statut éditorial
Publié
Date de publication
2012
Peer-reviewed
Oui
Volume
97
Numéro
10
Pages
1594-1602
Langue
anglais
Notes
Publication types: Journal ArticlePublication Status: ppublish
Résumé
Background In angioimmunoblastic T-cell lymphoma, symptoms linked to B-lymphocyte activation are common, and variable numbers of CD20(+) large B-blasts, often infected by Epstein-Barr virus, are found in tumor tissues. We postulated that the disruption of putative B-T interactions and/or depletion of the Epstein-Barr virus reservoir by an anti-CD20 monoclonal antibody (rituximab) could improve the clinical outcome produced by conventional chemotherapy. DESIGN AND METHODS: Twenty-five newly diagnosed patients were treated, in a phase II study, with eight cycles of rituximab + chemotherapy (R-CHOP21). Tumor infiltration, B-blasts and Epstein-Barr virus status in tumor tissue and peripheral blood were fully characterized at diagnosis and were correlated with clinical outcome. RESULTS: A complete response rate of 44% (95% CI, 24% to 65%) was observed. With a median follow-up of 24 months, the 2-year progression-free survival rate was 42% (95% CI, 22% to 61%) and overall survival rate was 62% (95% CI, 40% to 78%). The presence of Epstein-Barr virus DNA in peripheral blood mononuclear cells (14/21 patients) correlated with Epstein-Barr virus score in lymph nodes (P<0.004) and the detection of circulating tumor cells (P=0.0019). Despite peripheral Epstein-Barr virus clearance after treatment, the viral load at diagnosis (>100 copy/μg DNA) was associated with shorter progression-free survival (P=0.06). Conclusions We report here the results of the first clinical trial targeting both the neoplastic T cells and the microenvironment-associated CD20(+) B lymphocytes in angioimmunoblastic T-cell lymphoma, showing no clear benefit of adding rituximab to conventional chemotherapy. A strong relationship, not previously described, between circulating Epstein-Barr virus and circulating tumor cells is highlighted.
Pubmed
Web of science
Open Access
Oui
Création de la notice
30/11/2012 11:49
Dernière modification de la notice
20/08/2019 16:02
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