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Rituxan (Rituximab)

Rituxan is the first of monoclonal antibodies to become commercially available for treatment of Lymphomas. This is a rather well tolerated drug that has shown reasonable efficacy against certain lymphomas. Rituxan is an antibody that selectively binds to CD-20 antigen on the surface of lymphoma cells. CD-20 is present in over 90% of low grade lymphomas. This drug also depletes normal CD-20 lymphocytes as well. Clinical trials with this drug have shown almost 50% response in patients who had have failed a prior chemotherapy and had progressive and refractory lymphoma. This drug is given intravenously, on a weekly basis for four weeks. The infusion should be slow and may be given in an out patient setting. Pre-medications with Tylenol and Benadryl should be used to prevent potential allergic reaction to this drug.

Side effects:

The first infusion is usually takes about 4-6 hours and may be associated with side effects as mentioned bellow. These side effects may be due to the destruction of both normal and malignant Lymphoma cells and release of substances from inside these cells. The subsequent infusions are better tolerated and may be associated with less side effects and can be given over 2-4 hours.

• Fever, Chills may happen in majority of patients and can be helped with using Tylenol prior to the administration of the drug.

• Nausea, vomiting

• Fatigue

• Skin Rash

• Low blood pressure

• Asthma and shortness on breath\

• Low White blood counts

• Low platelet counts

• Fluid retention

Destruction of normal lymphocytes does not seem to be associated with increased risk of infections,