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Previous Article | Table of Contents | Next Article 
Blood, 1 February 2002, Vol. 99, No. 3, pp. 1038-1043
NEOPLASIA
The mechanism of tumor cell clearance by rituximab in vivo in
patients with B-cell chronic lymphocytic leukemia: evidence
of caspase activation and apoptosis induction
John C. Byrd,
Shinichi Kitada,
Ian W. Flinn,
Jennifer L. Aron,
Michael Pearson,
David Lucas, and
John C. Reed
From the Division of Hematology-Oncology, The
Ohio State University, Columbus; Division of Hematologic Malignancies,
Johns Hopkins Oncology Center, Baltimore, MD; and Burnham Institute,
Cancer Research Center, La Jolla, CA.
Rituximab is a chimeric monoclonal antibody directed at CD20 with
significant activity in non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL). A variety of pathways of tumor cytotoxicity different from cytotoxic chemotherapy have been proposed for this therapeutic antibody including antibody-dependent cellular cytotoxicity and complement-mediated cell lysis. This report describes that a
proportion of patients with CLL receiving rituximab treatment have in
vivo activation of caspase-9, caspase-3, and poly(ADP-ribose) polymerase (PARP) cleavage in blood leukemia cells immediately following infusion of rituximab. This suggests that apoptosis using a
pathway similar to fludarabine and other chemotherapeutic agents is
intricately involved in the blood elimination of tumor cells after
rituximab treatment. Patients having caspase-3 activation and PARP
cleavage in vivo had a significantly lower blood leukemia cell count
after treatment as compared to those without caspase activation.
Significant down-modulation of the antiapoptotic proteins XIAP and
Mcl-1 was also noted, possibly explaining in part how rituximab
sensitizes CLL cells to the cytotoxic effect of chemotherapy in
vivo. These findings suggest that the therapeutic benefit of antibody-based therapy in vivo for patients with CLL depends in part on
induction of apoptosis and provides another area of focus for studying
mechanisms of antibody-resistance in neoplastic cells.

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J. C. Byrd, L. Smith, M. L. Hackbarth, I. W. Flinn, D. Young, J. H. Proffitt, and N. A. Heerema
Interphase Cytogenetic Abnormalities in Chronic Lymphocytic Leukemia May Predict Response to Rituximab
Cancer Res.,
January 1, 2003;
63(1):
36 - 38.
[Abstract]
[Full Text]
[PDF]
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W. L. Carroll, D. Bhojwani, D.-J. Min, E. Raetz, M. Relling, S. Davies, J. R. Downing, C. L. Willman, and J. C. Reed
Pediatric Acute Lymphoblastic Leukemia
Hematology,
January 1, 2003;
2003(1):
102 - 131.
[Abstract]
[Full Text]
[PDF]
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J. C. Byrd, B. L. Peterson, V. A. Morrison, K. Park, R. Jacobson, E. Hoke, J. W. Vardiman, K. Rai, C. A. Schiffer, and R. A. Larson
Randomized phase 2 study of fludarabine with concurrent versus sequential treatment with rituximab in symptomatic, untreated patients with B-cell chronic lymphocytic leukemia: results from Cancer and Leukemia Group B 9712 (CALGB 9712)
Blood,
January 1, 2003;
101(1):
6 - 14.
[Abstract]
[Full Text]
[PDF]
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I. M. Pedersen, S. Kitada, L. M. Leoni, J. M. Zapata, J. G. Karras, N. Tsukada, T. J. Kipps, Y. S. Choi, F. Bennett, and J. C. Reed
Protection of CLL B cells by a follicular dendritic cell line is dependent on induction of Mcl-1
Blood,
August 13, 2002;
100(5):
1795 - 1801.
[Abstract]
[Full Text]
[PDF]
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N. E. Kay, T. J. Hamblin, D. F. Jelinek, G. W. Dewald, J. C. Byrd, S. Farag, M. Lucas, and T. Lin
Chronic Lymphocytic Leukemia
Hematology,
January 1, 2002;
2002(1):
193 - 213.
[Abstract]
[Full Text]
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