Non-Hodgkin Lymphoma Research Paper

Immunotherapies combat cancer by utilizing the body’s own immune system. By activating the immune system to specifically target cancer cells, many of the side effects of conventional chemotherapies due to the nonspecific killing of healthy cells, such as hair loss, are avoided. The most common non-Hodgkin lymphoma (NHL) is Diffuse large B-cell lymphoma (DLBCL), which comprises approximately 30% of all new diagnoses.1 The median age of those presenting is mid-60s. The cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy regimen has been the foundation of treatment since its development in the 1970s.2 CHOP has remained the standard of care since attempts to improve outcomes with more intensive chemotherapy regimens failed

Since conventional chemotherapeutic drugs target and kill dividing cells, the side effects of chemotherapy involve healthy body tissues where cells are constantly growing and dividing, such as hair, bone marrow, skin, etc. Normal cells can still replace the dead cells or repair the healthy cells that are damaged by chemotherapy once treatment ceases. The CD20 receptor is only expressed by normal B cells but is absent on other normal cell types, such as precursor B cells, dendritic cells, and plasma cells, in a healthy individual. More importantly, 95% of B-cell NHLs and other B-cell malignancies also express CD-20, which makes it an ideal therapeutic target.6 CD-20 antibodies only target cells where the CD-20 receptor is expressed, i.e., solely B-cells. Therefore, the classic side effects of chemotherapy are avoided with rituximab. Interestingly, the biological function of CD20 is still unclear, although some evidence suggests a role in Ca2+ ion influx and homeostasis.7 CD20 has no known natural ligand, and CD20 mutant mice have a nearly normal phenotype.8 Once bound to B cells, rituximab induces lysis through several possible mechanisms: induced apoptosis (programmed cell death),