**7.1 Rituximab**

Rituximab is achimeric anti-CD20 human monoclonal IgG1 effective directly on the surface receptor found on typical pre-B and mature B cell of non-Hodgkin's lymphoma subtypes, driving to cell cytotoxicity and cell death [53]. It was at first utilized in aggressive and very aggressive relapsed or refractory lymphoma and demonstrated safety with disease regression and free survival [54].

Major toxicities patients with NHL include infusion-related fever chills, fatigue, pruritus, nausea, and vomiting, angioedema, *headache, hypotension, bronchospasm*, urticaria during the first infusion. Rituximab was approved in November 1997 for medical use of refractory or relapsed lymphoma (B-cell). Rituximab play excellent role in combination with chemotherapy and represents a paradigm shift in treatment of lymphomas and improve the outcome for all CD20+ NHL and CLL [55].
