The Absence of CD20 Messenger RNA in Recurrent Cutaneous B-cell Lymphoma Following Rituximab Therapy

Authors

Yeshwant B. Rawal, Marquette UniversityFollow
Gerard J. Nuovo, The Ohio State University
Gwyn E. Frambach, The Ohio State University
Pierluigi Porcu, The Ohio State University
Robert A. Baiocchi, The Ohio State University
Cynthia M. Magro, Cornell University

Document Type

Article

Publication Date

10-2005

Publisher

Wiley

Source Publication

Journal of Cutaneous Pathology

Source ISSN

0303-6987

Original Item ID

DOI: 10.1111/j.0303-6987.2005.00305.x

Abstract

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.

Comments

Accepted version. Journal of Cutaneous Pathology, Vol. 32, No. 9 (October 2005): 616-621. DOI. © 2005 Wiley. Used with permission.

Recommended Citation

Rawal, Yeshwant B.; Nuovo, Gerard J.; Frambach, Gwyn E.; Porcu, Pierluigi; Baiocchi, Robert A.; and Magro, Cynthia M., "The Absence of CD20 Messenger RNA in Recurrent Cutaneous B-cell Lymphoma Following Rituximab Therapy" (2005). School of Dentistry Faculty Research and Publications. 536.
https://epublications.marquette.edu/dentistry_fac/536