Rituximab treatment for Sjogren syndrome-associated non-Hodgkin's lymphoma: case series

Rheumatol Int. 2012 Oct;32(10):3281-4. doi: 10.1007/s00296-011-2036-2. Epub 2011 Jul 30.

Abstract

Five per cent of patients with primary Sjogren's syndrome (pSS) develop malignant non-Hodgkin's lymphoma (NHL), usually of the mucosa-associated lymphoid tissue (MALT) and most frequently located in the major salivary glands. Rituximab (RTX), a chimeric monoclonal antibody against the CD20 molecule expressed on the surface of mature B cells that has been approved for the treatment of NHL, has been used to treat pSS-associated lymphoma. We have described two cases: one with MALT lymphoma in the parotid glands and the other with a rare thymus lymphoma accompanied by the rare complication of a bullous pneumopathy. Both were treated with RTX at haematological doses, which was unsuccessful in the patient with a salivary lymphoma; in the case of the patient with a thymus lymphoma, the mediastinum mass disappeared and did not relapse. Both patients experienced an improvement in the subjective symptoms of dryness, and their Schirmer's test and scialoscintigraphy results stabilised. The pulmonary bullae remained unchanged.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use*
  • Antineoplastic Agents / therapeutic use*
  • Blister / drug therapy
  • Blister / etiology
  • Female
  • Humans
  • Lung Diseases / drug therapy
  • Lung Diseases / etiology
  • Lymphoma, B-Cell, Marginal Zone / diagnosis
  • Lymphoma, B-Cell, Marginal Zone / drug therapy*
  • Lymphoma, B-Cell, Marginal Zone / etiology
  • Lymphoma, B-Cell, Marginal Zone / immunology
  • Parotid Neoplasms / diagnosis
  • Parotid Neoplasms / drug therapy*
  • Parotid Neoplasms / etiology
  • Parotid Neoplasms / immunology
  • Rituximab
  • Sjogren's Syndrome / complications*
  • Sjogren's Syndrome / diagnosis
  • Sjogren's Syndrome / immunology
  • Thymus Neoplasms / diagnosis
  • Thymus Neoplasms / drug therapy*
  • Thymus Neoplasms / etiology
  • Thymus Neoplasms / immunology
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents
  • Rituximab