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Rituximab for the treatment of corticosteroid-refractory chronic graft-versus-host disease
Authors:Takanori Teshima   Koji Nagafuji   Hideho Henzan   Koichi Miyamura   Ken Takase   Michihiro Hidaka   Toshihiro Miyamoto   Katsuto Takenaka   Koichi Akashi  Mine Harada
Affiliation:(1) Center for Cellular and Molecular Medicine, Kyushu University Graduate School of Medical Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan;(2) Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan;(3) Department of Hematology, Hamanomachi General Hospital, Fukuoka, Japan;(4) Department of Hematology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan;(5) Department of Internal Medicine, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
Abstract: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/m2 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.
Keywords:Rituximab  Chronic GVHD  Corticosteroids  Allogeneic transplantation
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