Rituximab (MabThera)

Rituximab (MabThera) is an artificial antibody that recognises and binds to the CD20 receptor on the surface of B-cells. It is used as a treatment for non-Hodgkin’s lymphoma and diffuse large B-cell lymphoma that is resistant to other types of chemotherapy. It is produced by Roche.

Rituximab has been used in for the treatment of HIV-related non-Hodgkin’s lymphoma in combination with chemotherapy regimens, such as cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) and cyclophosphamide, doxorubicin and etoposide (CDE), and antiretroviral therapy. Complete remission rates at the end of treatment have been above 70%.1 2 However, some studies have found no benefit of adding rituximab to chemotherapy combinations in terms of death rates, since the reduction in deaths due to the cancer are offset by an increased death rate due to infection, particularly in patients with CD4 cell counts below 50 cells/mm3.3

Rituximab can also be effective in controlling multicentric Castleman’s disease in HIV-positive patients, although this may worsen the symptoms of Kaposi’s sarcoma.4 5

Rituximab is administered by intravenous infusion and may cause side-effects such as fever, chills, nausea, vomiting, allergic reactions, flushing and tumour pain. Deaths have occurred within one to two hours of dosing so close monitoring is recommended during this time.

Rituximab should be used with caution in people with cardiovascular disease or a history of heart problems because rituximab may exacerbate these conditions.

References

  1. Boue F et al. Phase II trial of CHOP plus rituximab in patients with HIV-associated non-Hodgkin’s lymphoma. J Clin Oncol (online edition), 2006
  2. Spina M et al. Rituximab plus infusional cyclophosphamide, doxorubicin, and etoposide in HIV-associated non-Hodgkin lymphoma: pooled results from 3 phase 2 trials. Blood 105: 1891-1897, 2005
  3. Kaplan LD et al. Rituximab does not improve clinical outcome in a randomized phase 3 trial of CHOP with or without rituximab in patients with HIV-associated non-Hodgkin lymphoma: AIDS-Malignancies Consortium Trial 010. Blood 106: 1538-1543, 2005
  4. Casquero A et al. Use of rituximab as a salvage therapy for HIV-associated multicentric Castleman’s disease. Ann Hematol 85: 185-187, 2006
  5. Marcelin AG et al. Rituximab therapy for HIV-associated Castleman disease. Blood 102: 2786-2788, 2003

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Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.