Rituximab treatment before reduced-intensity conditioning transplantation associates with a decreased incidence of extensive chronic GVHD

Suzanne van Dorp; Floor Pietersma; Matthias Wölfl; Leo F Verdonck; Eefke J Petersen; Henk M Lokhorst; Edwin Martens; Matthias Theobald; Debbie van Baarle; Ellen Meijer; Jürgen Kuball

doi:10.1016/j.bbmt.2009.02.005

Rituximab treatment before reduced-intensity conditioning transplantation associates with a decreased incidence of extensive chronic GVHD

Biol Blood Marrow Transplant. 2009 Jun;15(6):671-8. doi: 10.1016/j.bbmt.2009.02.005. Epub 2009 Apr 16.

Authors

Suzanne van Dorp¹, Floor Pietersma, Matthias Wölfl, Leo F Verdonck, Eefke J Petersen, Henk M Lokhorst, Edwin Martens, Matthias Theobald, Debbie van Baarle, Ellen Meijer, Jürgen Kuball

Affiliation

¹ Department of Hematology and Van Creveld Clinic, UMC Utrecht, The Netherlands.

PMID: 19450751
DOI: 10.1016/j.bbmt.2009.02.005

Abstract

Chronic graft-versus-host-disease (cGVHD) is the major cause of late morbidity and mortality after allogeneic stem cell transplantation. B cells have been reported to be involved in mediating cGVHD. To assess whether preemptive host B cell depletion prevents extensive cGVHD after allogeneic reduced-intensity conditioning transplantation (RICT), 173 patients treated with RICT for various hematologic diseases, who had or had not received Rituximab (Rtx) within 6 month prior to RICT, were analyzed retrospectively. Rtx treatment within 6 months prior to RICT reduced extensive cGVHD significantly from 45.8% to 20.1%. We hypothesize that most likely host B cells initiate cGVHD, and thus, host B cell depletion prior to RICT by Rtx might be a valuable strategy to reduce extensive cGVHD after RICT.

Publication types

Comparative Study
Evaluation Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Alemtuzumab
Antibodies, Monoclonal / administration & dosage
Antibodies, Monoclonal / therapeutic use*
Antibodies, Monoclonal, Humanized
Antibodies, Monoclonal, Murine-Derived
Antibodies, Neoplasm / therapeutic use
Antilymphocyte Serum / administration & dosage
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
B-Lymphocytes / drug effects*
B-Lymphocytes / immunology
Chronic Disease
Combined Modality Therapy
Disease-Free Survival
Drug Administration Schedule
Female
Graft vs Host Disease / drug therapy
Graft vs Host Disease / etiology
Graft vs Host Disease / prevention & control*
Hematologic Diseases / drug therapy
Hematologic Diseases / surgery*
Humans
Immunosuppressive Agents / therapeutic use
Incidence
Kaplan-Meier Estimate
Lymphocyte Depletion / methods*
Male
Middle Aged
Patient Selection
Premedication
Retrospective Studies
Rituximab
Sample Size
Transplantation Conditioning / methods*
Young Adult

Substances

Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Antibodies, Monoclonal, Murine-Derived
Antibodies, Neoplasm
Antilymphocyte Serum
Immunosuppressive Agents
Alemtuzumab
Rituximab