Keypoints

Newly diagnosed non-Hodgkin's lymphoma

Monoclonal antibodies, most commonly rituximab, are used routinely in many centres in the initial treatment of many types of non-Hodgkin's lymphoma. In this case, rituximab is often given with chemotherapy, usually at the beginning of each treatment cycle, just before the chemotherapy.

Combining rituximab with chemotherapy has been shown to increase the average length of a patient's remission, or to increase the length of time patients survive after completing the treatment. In aggressive non-Hodgkin's lymphoma, the combination of rituximab with chemotherapy is becoming a standard treatment option for newly diagnosed patients. Rituximab does not add significantly to the side effects of chemotheraphy when used in this way.

Monoclonal antibody therapy is used routinely in many centres in the initial treatment of many types of non-Hodgkin's lymphoma

Evidence for monoclonal antibody therapy

There is now a lot of evidence that, in both indolent and aggressive patients with newly diagnosed non-Hodgkin's lymphoma, rituximab, in combination with chemotherapy, can increase survival. Results from clinical trials in indolent non-Hodgkin's lymphoma are also encouraging.

In aggressive non-Hodgkin's lymphoma, the combination of rituximab with standard chemotherapy (CHOP) has been shown to increase a patient's chance of obtaining a cure without a significant increase in side effects.

Rituximab is also being used in the initial treatment of most types of indolent non-Hodgkin's lymphoma. Again, it has potential benefits, in that it may increase the effectiveness of other treatments (usually chemotherapy) without causing any significant increase in side effects.

Studies in patients with previously untreated indolent non-Hodgkin's lymphoma have shown that adding rituximab to standard combination chemotherapy both improves the chances of a patient responding to treatment, as well as increasing the duration of the remission experienced by those who respond.