经利妥昔单抗治疗后复发的皮肤B细胞淋巴瘤出现CD20信使RNA缺失
The absence of CD20 messenger RNA in recurrent cutaneous B- cell lymphoma following rituximab therapy
关键词
Background:
RITUXIMAB
has
been
used
to
TREAT
relap
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.
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