Rituximab is a chimeric monoclonal antibody anti-CD20. CD20 receptor is expressed on cells of many B-lymphoproliferative diseases and is constantly presented on cells of follicular lymphoma. The effective mechanism is antibody- (ADCC) and complement-dependent cytotoxicity (CDC). There is also evidence of direct induction of apoptosis and inhibition of proliferation. The usual dosage of rituximab is 4x375mg/m2 in slow infusion, applied in weekly intervals. A synergism of rituximab with many cytostatics was demonstrated in vitro and also confirmed in clinical studies. Rituximab toxicity is very low and manifests usually with a moderate allergic reaction in the course of administration of the first infusion. In monotherapy, rituximab leads in relapsing and resistent patients with follicular lymphoma to 46-48 % of overall response (OR) and 2-6 % complete remission (CR), whereas in primary treatment, up to 70 % OR and 20 % CR have been reported. Immunochemotherapy (rituximab combination with chemotherapy) is even more efficient. The CHOP/rituximab regime reached 95-100 % OR and 54-58 % CR, corresponding results have been described even after combinations of fludarabin regime with rituximab. Rituximab was also administered in combination with different cytokines. The efficiency of rituximab with IFNα was between 45-71 % OR, combination of rituximab with IL-2, IL-12 and G-CSF reached around 67-69 % OR. Rituximab is used as an efficient method of purging in vivo before collection of peripheral stem cells and in maintenance therapy after autologous transplantation of peripheral stem cells.

        Key words: rituximab, mabthera, monoclonal antibodies, follicular lymphoma