Identification of patients with indolent B cell lymphoma sensitive to rituximab monotherapy

The potential predictive value of tumor bulk, genetic, and immunological variants in patients with low-grade non-Hodgkin's lymphoma to respond to treatment with rituximab (RTX) monotherapy was evaluated. Thus, the value of assessing the effect of 18-fluoro-desoxy-d-glucose (FDG) uptake on PET scan, polymorphisms in Fc gamma receptor (Fc gamma R) IIIa-158, Fc gamma RIIa-131, and C1qA-276 genes in predicting the response to treatment were evaluated in 50 low-grade non-Hodgkin's lymphoma patients. The influence of RTX pharmacokinetics, plasma levels of the B cell-activating factor (BAFF), and human antichimeric antibodies was also investigated. The therapeutic response was evaluated 10 weeks after treatment using revised Cheson's criteria. Lower maximal standardized uptake values (SUVmax) at baseline were predictive of complete response. Fc gamma RIIIa-158 polymorphism was also associated with complete response to RTX confirming previous findings, whereas polymorphisms in the Fc gamma RIIa-131 and C1qA-276 genes were not. Lower blood levels of RTX were observed in males, but the effectiveness of RTX in males and females was the same. BAFF was not detectable in plasma before or after treatment, and no patients developed human antichimeric antibodies. Low-grade non-Hodgkin's lymphoma patients with a low SUVmax at baseline and an Fc gamma RIIIa-158 V/V genotype generally had a complete response to RTX.