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Briefing Note - rituximab (MabThera)

SMC has accepted rituximab for the first-line treatment of patients with chronic lymphocytic leukaemia in combination with fludarabine and cyclophosphamide (drugs used in chemotherapy). It should only be used by doctors who have expertise in blood diseases and cancers of the blood.

  • Chronic lymphocytic leukaemia (CLL) is the most common type of leukaemia (cancer of the white blood cells). Healthy white blood cells develop in the bone marrow and help to fight infection. In CLL, the white blood cells are not fully developed and multiply out of control crowding out healthy blood cells that can fight infection. CLL usually develops very slowly and many people with CLL do not need treatment for months or years.
  • CLL is treated by surgery, drugs, radiation or a combination of radiation and drugs (known as radiotherapy and chemotherapy). Rituximab is a type of anti-cancer drug called a monoclonal antibody. It binds to the abnormal cells and helps to destroy them while having no effect on healthy blood cells. Rituximab is given via a drip.
  • Patients treated with rituximab together with fludarabine and cyclophosphamide survived without progression of the disease for about 7 months longer than patients treated with fludarabine and cyclophosphamide alone.
  • No new safety concerns have been identified with rituximab used in conjunction with chemotherapy in this setting, although there was a higher incidence of blood and lymphatic disorders reported in the rituximab group, in particular neutropenia (low number of a type of white blood cells called neutrophils) and leucopenia (a decrease in the number of white blood cells).
  • SMC accepted rituximab for restricted use because it is effective and offers good value for money.