Article: Rituximab

Rituximab, sold under the trade names Rituxan® and MabThera®, is a monoclonal antibody used in the treatment of B cell non-Hodgkin's lymphoma, B cell leukemia, and some autoimmune disorders.

History

Rituximab initially was approved by the FDA in 1997 for lymphoma that was refractory to other chemotherapy regimens. The original approval followed the availability of the McLaughlin et al^[1] study data. It now is standard therapy in the initial treatment of aggressive lymphomas (e.g. diffuse large B cell lymphoma) in combination with CHOP chemotherapy.

Mechanism

The antibody binds to the cluster of differentiation 20 (CD20) found on the surface of B cells, flagging them for destruction by the body's own immune system. This eliminates B cells (including the cancerous ones) from the body, allowing a new population of healthy B cells to develop from lymphoid stem cells. The actual mechanisms for Rituximab to eliminate B cells includes the induction of ADCC, CDC, and apoptosis.

Non-cancer use

Rituximab has been found to be effective in the treatment of immune thrombocytopenic purpura (ITP) in various trials.^[2] It also seems to be effective in threatment of systemic lupus erythematosus and rheumatoid arthritis.^[3]

Transplant use

Rituximab is now being used in the management of Renal Transplant recipients. This drug is especially useful in transplants involving incompatible blood groups. It is also used as induction therapy in highly sensitised patients going for renal translplantation.