Common brand names

• Riabni
• Rituxan
• Ruxience
• Truxima

How it is administered

Rituximab is given as an intravenous (IV) infusion, which means it is delivered directly into a vein by a healthcare professional. The medication comes in single-dose vials and is diluted before administration. The dosing schedule and number of infusions depend on the condition being treated and your treatment plan. For follicular lymphoma, it is often given in cycles, sometimes in combination with chemotherapy.

There is also a subcutaneous (under the skin) formulation available, but the most common method for follicular lymphoma is IV infusion.

How it works

Rituximab is a monoclonal antibody that targets a protein called CD20 found on the surface of certain B-cells (a type of white blood cell). In follicular lymphoma, these B-cells become cancerous and multiply uncontrollably. Rituximab binds to the CD20 protein, which helps your immune system recognize and destroy these abnormal B-cells.

The destruction of B-cells occurs through several mechanisms, including direct cell death, activation of the immune system to attack the cells (antibody-dependent cell-mediated cytotoxicity), and activation of the complement system (complement-dependent cytotoxicity). By reducing the number of abnormal B-cells, rituximab helps control the growth and spread of follicular lymphoma.

After treatment, normal B-cells usually recover over time, but it may take several months to a year for them to return to normal levels.

Who should take it

Rituximab is indicated for adults with follicular lymphoma in several situations:

• As a single agent for relapsed or refractory follicular lymphoma (when the disease has come back or not responded to other treatments).
• In combination with first-line chemotherapy for previously untreated follicular lymphoma.
• As maintenance therapy (single-agent) in patients who have responded to rituximab plus chemotherapy.
• As a single agent for patients with non-progressing (including stable disease) follicular lymphoma after first-line cyclophosphamide, vincristine, and prednisone (CVP) chemotherapy.

Your doctor will determine if rituximab is appropriate for you based on your disease stage, previous treatments, and overall health.

Who should not take it

Rituximab should not be used in patients with a known severe allergic reaction (hypersensitivity) to rituximab or any of its components. There are no absolute contraindications listed, but caution is needed in certain situations:

• Patients with active, severe infections should not start rituximab until the infection is controlled.
• Patients with a history of hepatitis B infection must be screened and monitored closely, as rituximab can cause reactivation of hepatitis B.
• It is not recommended for use in pregnant women, as it can harm the unborn baby.
• Live virus vaccines should not be given before or during rituximab treatment.

Always discuss your full medical history with your healthcare provider before starting rituximab.

Commonly used with

Rituximab is often used in combination with chemotherapy regimens for follicular lymphoma, such as:

• CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)
• CVP (cyclophosphamide, vincristine, prednisone)
• Bendamustine

It may also be used as a single agent for maintenance therapy after initial treatment with chemotherapy and rituximab.

Your doctor will decide the best combination based on your specific situation.

Commonly tested with

Rituximab has been tested in combination with various chemotherapy regimens in clinical trials for follicular lymphoma, including:

• CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)
• CVP (cyclophosphamide, vincristine, prednisone)
• Bendamustine
• Fludarabine and cyclophosphamide (more common in chronic lymphocytic leukemia)

It is also studied as a single agent for maintenance therapy after initial combination treatment.