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Blood, Vol. 95 No. 12 (June 15), 2000:
pp. 3900-3908
Biologic response of B lymphoma cells to anti-CD20 monoclonal
antibody rituximab in vitro: CD55 and CD59 regulate complement-mediated
cell lysis
Josée Golay,
Luisella Zaffaroni,
Thomas Vaccari,
Manuela Lazzari,
Gian-Maria Borleri,
Sergio Bernasconi,
Francesco Tedesco,
Alessandro Rambaldi, and
Martino Introna
From the Istituto Ricerche Farmacologiche "Mario Negri,"
Milan; the Hematology Division, Ospedali Riuniti, Bergamo; and the
Department of Physiology and Pathology, University of Trieste, Trieste,
Italy.
The chimeric anti-CD20 MAb rituximab has recently become a treatment
of choice for low-grade or follicular non-Hodgkin's lymphomas (FL)
with a response rate of about 50%. In this report, we have investigated the mechanism of action of rituximab on 4 FL and 1 Burkitt's lymphoma (BL) cell lines, 3 fresh FL samples and normal B
cells in vitro. Rituximab efficiently blocks the proliferation of
normal B cells, but not that of the lymphoma lines. We did not detect
significant apoptosis of the cell lines in response to rituximab alone.
All cell lines were targets of antibody-dependent cellular cytotoxicity
(ADCC). On the other hand, human complement-mediated lysis was highly
variable between cell lines, ranging from 100% lysis to complete
resistance. Investigation of the role of the complement inhibitors
CD35, CD46, CD55, and CD59 showed that CD55, and to a lesser extent
CD59, are important regulators of complement-mediated cytotoxicity
(CDC) in FL cell lines as well as in fresh cases of FL: Blocking CD55
and/or CD59 function with specific antibodies significantly increased
CDC in FL cells. We conclude that CDC and ADCC are major mechanisms of
action of rituximab on B-cell lymphomas and that a heterogeneous
susceptibility of different lymphoma cells to complement may be at
least in part responsible for the heterogeneity of the response of
different patients to rituximab in vivo. Furthermore, we suggest that
the relative levels of CD55 and CD59 may become useful markers to
predict the clinical response.

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R. Stein, Z. Qu, S. Chen, A. Rosario, V. Shi, M. Hayes, I. D. Horak, H. J. Hansen, and D. M. Goldenberg
Characterization of a New Humanized Anti-CD20 Monoclonal Antibody, IMMU-106, and Its Use in Combination with the Humanized Anti-CD22 Antibody, Epratuzumab, for the Therapy of Non-Hodgkin's Lymphoma
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W. L. Gluck, D. Hurst, A. Yuen, A. M. Levine, M. A. Dayton, J. P. Gockerman, J. Lucas, K. Denis-Mize, B. Tong, D. Navis, et al.
Phase I Studies of Interleukin (IL)-2 and Rituximab in B-Cell Non-Hodgkin's Lymphoma: IL-2 Mediated Natural Killer Cell Expansion Correlations with Clinical Response
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J. M. Vose
Bexxar(R): Novel Radioimmunotherapy for the Treatment of Low-Grade and Transformed Low-Grade Non-Hodgkin's Lymphoma
Oncologist,
April 1, 2004;
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[Abstract]
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A. D. Kennedy, P. V. Beum, M. D. Solga, D. J. DiLillo, M. A. Lindorfer, C. E. Hess, J. J. Densmore, M. E. Williams, and R. P. Taylor
Rituximab Infusion Promotes Rapid Complement Depletion and Acute CD20 Loss in Chronic Lymphocytic Leukemia
J. Immunol.,
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S. S. Farag, I. W. Flinn, R. Modali, T. A. Lehman, D. Young, and J. C. Byrd
Fc{gamma}RIIIa and Fc{gamma}RIIa polymorphisms do not predict response to rituximab in B-cell chronic lymphocytic leukemia
Blood,
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[Abstract]
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C. F. Eisenbeis, M. A. Caligiuri, and J. C. Byrd
Rituximab: Converging Mechanisms of Action in Non-Hodgkin's Lymphoma?
Clin. Cancer Res.,
December 1, 2003;
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F. J. Hernandez-Ilizaliturri, V. Jupudy, J. Ostberg, E. Oflazoglu, A. Huberman, E. Repasky, and M. S. Czuczman
Neutrophils Contribute to the Biological Antitumor Activity of Rituximab in a Non-Hodgkin's Lymphoma Severe Combined Immunodeficiency Mouse Model
Clin. Cancer Res.,
December 1, 2003;
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[Abstract]
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W.-K. Weng and R. Levy
Two Immunoglobulin G Fragment C Receptor Polymorphisms Independently Predict Response to Rituximab in Patients With Follicular Lymphoma
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November 1, 2003;
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A. R. Jazirehi, X.-H. Gan, S. De Vos, C. Emmanouilides, and B. Bonavida
Rituximab (anti-CD20) selectively modifies Bcl-xL and apoptosis protease activating factor-1 (Apaf-1) expression and sensitizes human non-Hodgkin's lymphoma B cell lines to paclitaxel-induced apoptosis
Mol. Cancer Ther.,
November 1, 2003;
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M. Coleman, D. M. Goldenberg, A. B. Siegel, J. C. Ketas, M. Ashe, J. M. Fiore, and J. P. Leonard
Epratuzumab: Targeting B-Cell Malignancies through CD22
Clin. Cancer Res.,
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N. Di Gaetano, E. Cittera, R. Nota, A. Vecchi, V. Grieco, E. Scanziani, M. Botto, M. Introna, and J. Golay
Complement Activation Determines the Therapeutic Activity of Rituximab In Vivo
J. Immunol.,
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R. Loomis, R. Carbone, M. Reiss, and J. Lacy
Bcl-2 Antisense (G3139, Genasense) Enhances the in Vitro and in Vivo Response of Epstein-Barr Virus-associated Lymphoproliferative Disease to Rituximab
Clin. Cancer Res.,
May 1, 2003;
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K.-G. Fischer, B. Deschler, M. Lubbert, A. Wiestner, B. B. Weksler, and G. P. Schechter
Acquired high-titer factor VIII inhibitor: fatal bleeding despite multimodal treatment including rituximab preceded by multiple plasmaphereses
Blood,
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R. Bannerji, S. Kitada, I. W. Flinn, M. Pearson, D. Young, J. C. Reed, and J. C. Byrd
Apoptotic-Regulatory and Complement-Protecting Protein Expression in Chronic Lymphocytic Leukemia: Relationship to In Vivo Rituximab Resistance
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S. P. Bohen, O. G. Troyanskaya, O. Alter, R. Warnke, D. Botstein, P. O. Brown, and R. Levy
Variation in gene expression patterns in follicular lymphoma and the response to rituximab
PNAS,
February 18, 2003;
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[Abstract]
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O. Manches, G. Lui, L. Chaperot, R. Gressin, J.-P. Molens, M.-C. Jacob, J.-J. Sotto, D. Leroux, J.-C. Bensa, and J. Plumas
In vitro mechanisms of action of rituximab on primary non-Hodgkin lymphomas
Blood,
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[Abstract]
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M. S. Cragg, S. M. Morgan, H. T. C. Chan, B. P. Morgan, A. V. Filatov, P. W. M. Johnson, R. R. French, and M. J. Glennie
Complement-mediated lysis by anti-CD20 mAb correlates with segregation into lipid rafts
Blood,
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A. D. Kennedy, M. D. Solga, T. A. Schuman, A. W. Chi, M. A. Lindorfer, W. M. Sutherland, P. L. Foley, and R. P. Taylor
An anti-C3b(i) mAb enhances complement activation, C3b(i) deposition, and killing of CD20+ cells by rituximab
Blood,
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I. Semac, C. Palomba, K. Kulangara, N. Klages, G. van Echten-Deckert, B. Borisch, and D. C. Hoessli
Anti-CD20 Therapeutic Antibody Rituximab Modifies the Functional Organization of Rafts/Microdomains of B Lymphoma Cells
Cancer Res.,
January 15, 2003;
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E. Boulanger, V. Meignin, G. Leverger, and P. Solal-Celigny
Rituximab monotherapy in nodular lymphocyte-predominant Hodgkin's disease
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A. L. Rose, B. E. Smith, and D. G. Maloney
Glucocorticoids and rituximab in vitro: synergistic direct antiproliferative and apoptotic effects
Blood,
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M. A. Dimopoulos, C. Zervas, A. Zomas, C. Kiamouris, N. A. Viniou, V. Grigoraki, C. Karkantaris, C. Mitsouli, D. Gika, J. Christakis, et al.
Treatment of Waldenstrom's Macroglobulinemia With Rituximab
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I. M. Pedersen, A. M. Buhl, P. Klausen, C. H. Geisler, and J. Jurlander
The chimeric anti-CD20 antibody rituximab induces apoptosis in B-cell chronic lymphocytic leukemia cells through a p38 mitogen activated protein-kinase-dependent mechanism
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G. Cartron, L. Dacheux, G. Salles, P. Solal-Celigny, P. Bardos, P. Colombat, and H. Watier
Therapeutic activity of humanized anti-CD20 monoclonal antibody and polymorphism in IgG Fc receptor Fcgamma RIIIa gene
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A. Rambaldi, M. Lazzari, C. Manzoni, E. Carlotti, L. Arcaini, M. Baccarani, T. Barbui, C. Bernasconi, G. Dastoli, G. Fuga, et al.
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S. M. Ansell, T. E. Witzig, P. J. Kurtin, J. A. Sloan, D. F. Jelinek, K. G. Howell, S. N. Markovic, T. M. Habermann, G. G. Klee, P. J. Atherton, et al.
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J. Golay, M. Lazzari, V. Facchinetti, S. Bernasconi, G. Borleri, T. Barbui, A. Rambaldi, and M. Introna
CD20 levels determine the in vitro susceptibility to rituximab and complement of B-cell chronic lymphocytic leukemia: further regulation by CD55 and CD59
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B. Bellosillo, N. Villamor, A. Lopez-Guillermo, S. Marce, J. Esteve, E. Campo, D. Colomer, and E. Montserrat
Complement-mediated cell death induced by rituximab in B-cell lymphoproliferative disorders is mediated in vitro by a caspase-independent mechanism involving the generation of reactive oxygen species
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W.-K. Weng and R. Levy
Expression of complement inhibitors CD46, CD55, and CD59 on tumor cells does not predict clinical outcome after rituximab treatment in follicular non-Hodgkin lymphoma
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O. W. Press, J. P. Leonard, B. Coiffier, R. Levy, and J. Timmerman
Immunotherapy of Non-Hodgkin's Lymphomas
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