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Rituximab + autologous serum is an investigational combination immunotherapy regimen used for the treatment of relapsed or refractory CD20+ indolent conjunctival lymphoma, such as mucosa-associated lymphoid tissue (MALT) lymphoma. This therapeutic approach was investigated in the Phase II IRIS (Intralesional Rituximab for Conjunctival Lymphoma) trial led by Dr. Andrés J. M. Ferreri at the San Raffaele Scientific Institute. The protocol involves the intralesional injection of the anti-CD20 monoclonal antibody rituximab. In cases where patients do not respond to rituximab monotherapy, 500 μL of the patient's own blood serum (autologous serum) is added to the injection. The rationale for this supplementation is that the autologous serum provides essential immune effectors, particularly complement proteins, which may be deficient in the local tumor microenvironment. By replenishing these effectors, the serum enhances rituximab's ability to induce complement-dependent cytotoxicity (CDC) and antibody-dependent cellular cytotoxicity (ADCC), thereby overcoming local resistance and improving antitumor activity.
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