Abstract
Purpose:
To retrospectively review the clinical course of systemic rituximab for treating ocular adnexal mucosa-associated lymphoid tissue-type (MALT) lymphoma.
Methods:
Twenty patients (10 men, 10 women) with stage I MALT adnexal lymphoma between 1993 and 2012 at Osaka University Hospital were included. We reviewed the clinical courses of 8 (2 men, 6 women, average age, 63.7±11.5) of the 20 cases treated with adjunctive rituximab therapy. The pathological diagnosis of all cases obtained intraoperatively was CD20-positive MALT lymphoma. Weekly rituximab infusions for 4 weeks were administered as a one-course protocol; additional injections were administered with disease recurrence. We investigated the effects and the clinical course of rituximab treatment and the relationship between serum sIL-2R concentrations and the recurrence rate.
Results:
The mean follow-up time was 72.0±34.5 months. The mean number of rituximab infusions was 6.8±3.2 (range, 4-12). The mean follow-up time after administration was 44.3±34.9 months. Malignant lymphoma involved the conjunctiva in 2 cases and extended into the orbit in 6 cases. Tumor regression occurred immediately after the one-course protocol. Among the eight cases, three cases had relapses after the initial treatment; two of these cases initially had multiple relapses despite prior systemic monochemotherapy. Remission ultimately was achieved with several courses of rituximab. In another case, after initial rituximab treatment induced tumor regression, a long remission was obtained with adjunctive radiation therapy. The serum sIL-2R concentrations were significantly higher in cases with relapses than in those without relapses.
Conclusions:
Systemic rituximab therapy could be a good option for treating orbital MALT lymphoma. Periodic examinations are needed until remission is achieved since single-modality therapy could cause a relapse. The sIL-2R concentration could be a good biomarker for recurrence.
Keywords: 624 oncology •
555 immunomodulation/immunoregulation •
744 tumors