TY - JOUR AU - Marie-Hélène Delfau-Larue, AU - Laurence de Leval, AU - Bertrand Joly, AU - Anne Plonquet, AU - Dominique Challine, AU - Marie Parrens, AU - Alain Delmer, AU - Gilles Salles, AU - Franck Morschhauser, AU - Richard Delarue, AU - Pauline Brice, AU - Reda Bouabdallah, AU - Olivier Casasnovas, AU - Hervé Tilly, AU - Philippe Gaulard, AU - Corinne Haioun, PY - 2012/10/09 Y2 - 2024/03/28 TI - Targeting intratumoral B cells with rituximab in addition to CHOP in angioimmunoblastic T-cell lymphoma. A clinicobiological study of the GELA JF - Haematologica JA - haematol VL - 97 IS - 10 SE - Original Articles and Brief Reports DO - 10.3324/haematol.2011.061507 UR - https://haematologica.org/article/view/6446 SP - 1594-1602 AB - Background In angioimmunoblastic T-cell lymphoma, symptoms linked to B-lymphocyte activation are common, and variable numbers of CD20+ large B-blasts, often infected by Epstein-Barr virus, are found in tumor tissues. We postulated that the disruption of putative B-T interactions and/or depletion of the Epstein-Barr virus reservoir by an anti-CD20 monoclonal antibody (rituximab) could improve the clinical outcome produced by conventional chemotherapy.Design and Methods Twenty-five newly diagnosed patients were treated, in a phase II study, with eight cycles of rituximab + chemotherapy (R-CHOP21). Tumor infiltration, B-blasts and Epstein-Barr virus status in tumor tissue and peripheral blood were fully characterized at diagnosis and were correlated with clinical outcome.Results A complete response rate of 44% (95% CI, 24% to 65%) was observed. With a median follow-up of 24 months, the 2-year progression-free survival rate was 42% (95% CI, 22% to 61%) and overall survival rate was 62% (95% CI, 40% to 78%). The presence of Epstein-Barr virus DNA in peripheral blood mononuclear cells (14/21 patients) correlated with Epstein-Barr virus score in lymph nodes (P100 copy/μg DNA) was associated with shorter progression-free survival (P=0.06).Conclusions We report here the results of the first clinical trial targeting both the neoplastic T cells and the microenvironment-associated CD20+ B lymphocytes in angioimmunoblastic T-cell lymphoma, showing no clear benefit of adding rituximab to conventional chemotherapy. A strong relationship, not previously described, between circulating Epstein-Barr virus and circulating tumor cells is highlighted. ER -