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Lymphoma - B cell neoplasms

B cell disorders

Post-rituximab


Reviewer: Nikhil Sangle, M.D., University of Utah and ARUP Laboratories (see Reviewers page)
Revised: 2 February 2011, last major update February 2011
Copyright: (c) 2001-2011, PathologyOutlines.com, Inc.

General
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● Rituximab is an anti-CD20 antibody widely used to treat lymphoma
● Loss of CD20 expression is common at relapse of aggressive B cell lymphoma treated with rituximab (Br J Haematol 2002;119:412)
● Post-rituximab, tumors may show loss of CD20 expression with proliferation of plasmacytoid cells, transformation to classic Hodgkin's lymphoma or transformation to an anaplastic large cell lymphoma-like undifferentiated lymphoma (Cancer Sci 2009;100:54)
● Recurrent CD20 negative cases are often clonally related to pre-rituximab tumor (Leuk Lymphoma 2002;43:2335)
● Bone marrow specimens may contain T cell aggregates that suggest relapse, so ordering immunostains is important (Am J Clin Path 1999;112:844)
● CD79a and Pax-5 should be used as the first-line B lineage-specific markers to detect CD20 negative mature B-cell lymphomas; if negative, OCT.2 or BOB.1 may be useful (Am J Clin Path 2006;126:534)
● CD20 antigen may reappear after relapse of CD20-negative tumor (Haematologica 2007;92:e1)

Micro images
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Reappearance of CD20 antigen after relapse of CD20 negative tumor

End of Lymphoma - B cell neoplasms > B cell disorders > Post-rituximab


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