Selection of rituximab dosage in chronic lymphocytic leukemia: Where is the evidence?

Abstract

Rituximab prolongs survival in many CD20-expressing B-lymphoid malignancies. In non-Hodgkin lymphoma (NHL), a large number of clinical studies have established the 375 mg/m2 dose of rituximab as standard. In chronic lymphocytic leukemia (CLL), response rates to single-agent rituximab at the NHL dose were low, but the use of higher doses or more frequent dosing have led to improved response rates, suggesting that a higher dose may be required. This led to the empiric decision to adopt rituximab at 500 mg/m2 in combination with fludarabine and cyclophosphamide (FC) in phase II and III trials in CLL. The final result was the approval of rituximab at 500 mg/m 2 for treatment of CLL, in combinati..