Patients with follicular lymphoma ineligible for standard treatment with the anti-CD20 antibody rituximab represent a considerable challenge as they require alternative therapeutic approaches.
Patient and methods
We describe a patient who experienced a severe episode of serum sickness. Antichimeric antibodies against rituximab were verified in an early stage of disease, rendering further use of the drug impossible. After five treatment lines he developed progressive follicular lymphoma with skin involvement, which was treated with lenalidomide monotherapy.
Six cycles of lenalidomide monotherapy (25 mg orally for 21 days, 1 week off) led to a very good partial response rendering the patient eligible for autologous stem cell transplantation. Data on efficacy of lenalidomide in follicular lymphoma are reviewed.
As shown here, single-agent lenalidomide represent a therapeutic option for pretreated patients with follicular lymphoma ineligible for rituximab.