Concurrent Administration of Rituximab and CHOP Chemotherapeutic Agents for Outpatients with CD20-positive Lymphoma
R (rituximab)-CHOP (cyclophosphamide, adriamycin, vincristin, and prednisone) is given to outpatients with CD20-positive
lymphoma as a standard treatment. However, this regimen requires long-term infusion because of the necessity for monitoring the
infusion reaction (IR) during R administration. In this study, pharmacological changes in anti-tumor agents were examined after the joint
use of R and CHOP, and the possibility of concurrent administration of R and CHOP for outpatients was discussed. After combining antitumor
agents with R, the binding capacity of R to the CD20 peptide and molecular changes in anti-tumor agents were measured by
ELISA and LC/MS/MS-based analysis. At the same time, a pilot study involving concurrent administration of R and CHOP to patients
with diffuse large B-cell lymphoma (DLBCL) was carried out after the first course of R-CHOP. After combining with either adriamycin
or cyclophosphamide, the binding capacity of R to the CD20 antigen was equivalent to controls, and no molecular changes in adriamycin
and cyclophosphamide were detected after combination with R. Twenty-one cases of DLBCL were treated safely with concurrent
administration of R and CHOP. Twenty patients achieved complete remission after a full course of R-CHOP. The results indicated that
long-term medication might not be necessary for outpatients treated with R-CHOP.
Keywords: Concurrent administration, KLH-CD20 peptide, LC/MS/MS, R-CHOP, Rituximab, lymphocytes, Prognostic Index, Antitumor agents, amino acids, adriamycin.
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