Rituximab and chemotherapy for lymphoma
This page is about having rituximab and chemotherapy together for non Hodgkin's lymphoma (NHL). There is information about
Rituximab is a monoclonal antibody used to treat some types of B cell non Hodgkin's lymphoma. It is a type of drug that attaches to the lymphoma cells. And then it brings in other cells from your immune system to kill the cancer cells. It can be used to treat both low grade and high grade B cell NHL. Most non Hodgkin's lymphomas are B cell lymphomas. Rituximab has been tested with chemotherapy in clinical trials. We know from research that adding rituximab to chemotherapy combinations improves survival in many lymphomas.
In high grade B cell NHL, rituximab is often used with a chemotherapy combination called CHOP, making R-CHOP. Along with rituximab, R-CHOP includes the drugs cyclophosphamide, doxorubicin (adriamycin) and vincristine, and a steroid called prednisolone. In the UK, the National Institute for Health and Clinical Excellence (NICE) has approved R-CHOP for patients with high grade B cell NHL at stage 2 or above.
Rituximab is also combined with the chemotherapy drugs dexamethasone (a steroid), cytarabine, and cisplatin to make R-DHAP for high grade NHL that has come back.
Follicular lymphoma is a type of low grade B cell NHL. NICE has approved rituximab with chemotherapy as treatment for people with stage 3 or 4 follicular lymphoma that has come back after previous treatment (relapsed). The treatment aims to get rid of all signs of the lymphoma (to induce remission). Rituximab can also be used alone as a maintenance during remission.
Rituximab has also been approved to treat stage 3 and 4 follicular lymphoma in combination with the chemotherapy drugs cyclophosphamide, vincristine, and prednisolone (CVP). This treatment is for people who are having symptoms and have not had any treatment before. We have information about R-CVP in the cancer drug section of CancerHelp UK.
Rituximab can also be used alone as a treatment when other treatments have not worked.
So far, the most common side effect with these treatments is a lowering of blood cell counts. This is due to the chemotherapy, and usually the blood counts get back to normal quite quickly by themselves. But while your blood counts are low, you are more at risk of picking up an infection, and may have problems with bruising and bleeding (nosebleeds for example).
Rituximab has been reported to cause
- A high temperature (fever)
- Feeling sick
- Pain in affected lymph nodes
- Mild drop in blood pressure, with wheezing and a feeling of tightness in the throat
These side effects are a reaction to having the drug and usually go within a couple of hours. Serious side effects of rituximab are uncommon.
There is more about the treatment of NHL in the non Hodgkin's lymphoma section of CancerHelp UK. And details of current clinical trials testing rituximab and chemotherapy can be found on our clinical trials database. Choose 'lymphoma' from the dropdown list of cancer types.
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