Rituximab for the treatment of corticosteroid-refractory chronic graft-versus-host disease

被引:43
|
作者
Teshima, Takanori [1 ]
Nagafuji, Koji [2 ]
Henzan, Hideho [3 ]
Miyamura, Koichi [4 ]
Takase, Ken [3 ]
Hidaka, Michihiro [5 ]
Miyamoto, Toshihiro [1 ,2 ]
Takenaka, Katsuto [2 ]
Akashi, Koichi [1 ,2 ]
Harada, Mine [2 ]
机构
[1] Kyushu Univ, Grad Sch Med Sci, Ctr Cellular & Mol Med, Higashi Ku, Fukuoka 8128582, Japan
[2] Kyushu Univ, Grad Sch Med Sci, Dept Med & Biosyst Sci, Higashi Ku, Fukuoka 8128582, Japan
[3] Hamanomachi Gen Hosp, Dept Hematol, Fukuoka, Japan
[4] Japanese Red Cross Nagoya Daiichi Hosp, Dept Hematol, Nagoya, Aichi, Japan
[5] Natl Hosp Org, Kumamoto Med Ctr, Dept Internal Med, Kumamoto, Japan
关键词
Rituximab; Chronic GVHD; Corticosteroids; Allogeneic transplantation; ANTI-CD20; MONOCLONAL-ANTIBODY; CONSENSUS DEVELOPMENT PROJECT; BONE-MARROW-TRANSPLANTATION; WORKING GROUP-REPORT; MINOR HISTOCOMPATIBILITY ANTIGEN; STEM-CELL TRANSPLANTATION; CLINICAL-TRIALS; B-CELLS; CHRONIC GVHD; THERAPY;
D O I
10.1007/s12185-009-0370-x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We prospectively evaluated the safety and efficacy of the anti-CD20 chimeric monoclonal antibody rituximab for the treatment of corticosteroid-refractory chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation. Seven patients were treated with 375 mg/m(2) rituximab weekly for 4 consecutive weeks. Rituximab was well tolerated with no severe toxicity observed during treatment. At 1 year, 3 patients showed a partial response to rituximab therapy, 3 had stable disease, and 1 had progressive disease. Rituximab allowed a reduction in the dose of steroids in 4 patients. Responsive manifestations included mild to moderate skin and oral lesions, and immune hemolytic anemia, and thrombocytopenia. Severe manifestations involving the skin, fascia, and eye did not respond to treatment. These observations suggest that rituximab therapy may be effective for select patients with corticosteroid-refractory chronic GVHD that is not advanced.
引用
收藏
页码:253 / 260
页数:8
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