Effect of Patients’ Endocrine Status on Effectiveness of Treatment with Rituximab: State of the Art

YuV Komoza1, VA Komoza1, SV Chernavskii2, OA Rukavitsyn2

1 Bryansk Regional Oncology Dispensary, 96 Stanke Dimitrova pr-t, Bryansk, Russian Federation, 241033

2 Academician NN Burdenko Principal Military Clinical Hospital under the Ministry of Defence of the Russian Federation, 3 Gospital’naya pl., Moscow, Russian Federation, 105229

For correspondence: Yuliya Valer’evna Komoza, 96 Stanke Dimitrova pr-t, Bryansk, Russian Federation, 241033; e-mail: smile-32@mail.ru

For citation: Komoza YuV, Komoza VA, Chernavskii SV, Rukavitsyn OA. Effect of Patients’ Endocrine Status on Effectiveness of Treatment with Rituximab: State of the Art. Clinical oncohematology. 2017;10(2):187–90 (In Russ).

DOI: 10.21320/2500-2139-2017-10-2-187-190


The non-Hodgkin’s lymphoma morbidity rate is gradually increasing, and its peak is registered in patients aged 45–60 years. At the same time, the world population steadily becomes older. Monoclonal antibodies (Rituximab) have been used in the treatment of patients with CD20-positive lymphomas for more than 20 years. The use of this drug enhanced the effectiveness of the therapy significantly. However, when patients were divided into groups by age and sex, better results were obtained in the group of women over 60 years. The review presents the results of several studies which have analyzed the effectiveness of rituximab-based schemes in patients depending on their sex and age, using different dosages and administration regimens. The article also presents our personal conclusions about the possible causes of the differences in efficacy of the drug in some patient populations. Identification of the causes contributing to the improvement of the effectiveness of rituximab in elderly women may significantly change approaches to the treatment of lymphomas in patients of both sexes.

Keywords: non-Hodgkin’s lymphoma, rituximab, lymphoma therapy effectiveness, gender differences, age differences.

Received: November 30, 2016

Accepted: January 17, 2017

Read in PDF (RUS)pdficon


  1. Гранов А.М., Ильин Н.В. Лимфомы: Научно-практическое издание. СПб.: ФГУ «РНЦРХТ», 2010. С. 144–5.
    [Granov AM, Il’in NV. Limfomy: nauchno-prakticheskoe izdanie. (Lymphomas: scientific-and-practical publication.) Saint Petersburg: FGU RNTSRCHT Publ.; 2010. pp. 144–5. (In Russ)]
  2. Scott SD. Rituximab: a new therapeutic monoclonal antibody for non-Hodgkin’s lymphoma. Cancer Pract. 1998;6(3):195–7. doi: 10.1046/j.1523-5394.1998.006003195.x.
  3. Давыдов М.И., Ганцев Ш.Х. Онкология. М.: ГЭОТАР-Медиа, 2010. 920 с.
    [Davydov MI, Gantsev ShKh. Onkologiya. (Oncology.) Moscow: GEOTAR-Media Publ.; 2010. 920 p. (In Russ)]
  4. Гематология: национальное руководство. Под ред. О.А. Рукавицына. М.: ГЭОТАР-Медиа, 2015. — 776 с.
    [Rukavitsyn OA, ed. Gematologiya: natsional’noe rukovodstvo. (Hematology: national guidelines.) Moscow: GEOTAR-Media Publ.; 2015. 776 p. (In Russ)]
  5. Shah S, Geetha D. Place in therapy of rituximab in the treatment of granulomatosis with polyangiitis and microscopic polyangiitis. Immunotargets Ther. 2015;4:173–83. doi: 10.2147/ITT.S55516.
  6. Hoppe RT, Advani RH, Ai WZ, et al. Clinical Practice Guidelines in Oncology. Hodgkin Lymphoma, Version 2.2015. J Natl Compr Canc Netw. 2015;13(5):554–86.
  7. Salvi M, Vannucchi G, Curro N, et al. Efficacy of B-cell targeted therapy with Rituximab in patients with active moderate to severe Graves’ orbitopathy: A randomized controlled study. J Clin Endocrinol Metab. 2015;100(2):422–431. doi: 10.1210/jc.2014-3014.
  8. Stan MN, Garrity JA, Carranza Leon BG, et al. Randomized controlled trial of Rituximab in patients with Graves’ orbitopathy. J Clin Endocrinol Metab. 2015;100(2):432–41. doi: 10.1210/jc.2014-2572.
  9. Mondello P, Sindoni A, Pitini V, et al. Thyroid function, autoimmunity and nodules in hematological malignancies. Arch Endocrinol Metab. 2015;59(3):236–44. doi: 10.1590/2359-3997000000044.
  10. Гонтмахер Е. Проблема старения населения в России. Мировая экономика и международные отношения. 2012;1:22–9.
    [Gontmakher E. Problem of aging of the Russian population. Mirovaya ekonomika i mezhdunarodnye otnosheniya. 2012;1:22–29. (In Russ)]
  11. Дильман В.М. Эндокринологическая онкология: руководство для врачей. 2-е изд., перераб. и доп. Л.: Медицина, 1983. С. 42–5, 54–5.
    [Dil’man VM. Endokrinologicheskaya onkologiya: rukovodstvo dlya vrachei. (Endocrinological oncology: manual for physicians.) Leningrad: Meditsina Publ.; 1983. pp. 42–5, 54–5. (In Russ)]
  12. Ульрих Е.А., Урманчеева А.Ф. Онкологические аспекты заместительной менопаузальной гормональной терапии. Практическая онкология. 2009;10(2):76–81.
    [Ul’rikh EA, Urmancheeva AF. Oncological aspects of menopausal hormone replacement therapy. Prakticheskaya onkologiya. 2009;10(2):76–81. (In Russ)]
  13. Дедов И.И., Мельниченко Г.А. Эндокринология: учебная литература для студентов медицинских вузов. М.: Медицина, 2000. С. 323–8, 360, 386–9.
    [Dedov II, Mel’nichenko GA. Endokrinologiya: uchebnaya literature dlya studentov meditsinskikh vuzov. (Endocrinology: a textbook for medical students.) Moscow: Meditsina Publ.; 2000. pр. 323–8, 360, 386–9. (In Russ)]
  14. Vermeulen A, Rubens R, Verdonck L. Testosterone secretion and metabolism in male Senescence. J Clin Endocrinol Metabol. 1972;34(4):730–5. doi: 10.1210/jcem-34-4-730.
  15. Дедов И.И., Калиниченко С.Ю. Возрастной андрогенный дефицит у мужчин. М.: Практическая медицина, 2006. С. 38–58.
    [Dedov II, Kalinchenko SYu. Vozrastnoi androgennyi defitsit u muzhchin. (Age-related androgen deficiency in men.) Moscow: Prakticheskaya meditsina Publ.; 2006. pр. 38–58. (In Russ)]
  16. Muller C, Murawski N, Wiesen MH, et al. The role of sex and weight on rituximab clearance and serum elimination half-life in elderly patients with DLBCL. Blood. 2012;119(14):3276–84. doi: 10.1182/blood-2011-09-380949.
  17. Pfeundschuh M, Held G, Zeynalova S, et al. Increased rituximab (R) doses and effect on risk of elderly male patients with aggressive CD20+ B-cell lymphomas: results of the SEXIE-R-CHOP-14 trial of the DSHNHL. J Clin Oncol. 2014;32(Suppl):5s.
  18. Pfreundschuh M, Poeschel V, Zeynalova S, et al. Optimization of rituximab for the treatment of diffuse large B-cell lymphoma (II): extended rituximab exposure time in the SMARTE-R-CHOP-14 trial of the German High-Grade non-Hodgkin Lymphoma Study Group. J Clin Oncol. 2014;32(36):4127–33. doi: 10.1200/JCO.2013.54.6861.
  19. Pfreundschuh M, Muller C, Zeynalova S, et al. Suboptimal dosing of rituximab in male and female patients with DLBCL. Blood. 2014;123(5):640–6. doi: 10.1182/blood-2013-07-517037.
  20. Sarkozy C, Mounier N, Delmer A, et al. Impact of BMI and gender on outcomes in DLBCL patients treated with R-CHOP: a pooled study from the LYSA. Lymphoma. 2014;2014:1–12. doi: 10.1155/2014/205215.
  21. Берг М.Г. Гендерная специфичность лекарств: фармакологические различия между мужчинами и женщинами. Акушерство, гинекология, педиатрия. 2007;14:148.
    [Berg MG. Drug gender specificity: pharmacological difference between men and women. Akusherstvo, ginekologiya, pediatriya. 2007;14:148. (In Russ)]
  22. Kane EV, Roman E, Becker N, et al. Menstrual and reproductive factors, and hormonal contraception use: associations with non-Hodgkin lymphoma in a pooled analysis of InterLymph case-control studies. Ann Oncol. 2012;23(9):2362–74. doi: 10.1093/annonc/mds171.
  23. Eve HE, Carey S, Richardson SJ, et al. Single-agent lenalidomide in relapsed/refractory mantle cell lymphoma: results from a UK phase II study suggest activity and possible gender differences. Br J Haematol. 2012;159(2):154–63. doi: 10.1111/bjh.12008.