Successful treatment of refractory donor lymphocyte infusion‐induced immune‐mediated pancytopenia with rituximab |
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| Authors: | Itaru Kato MD Katsutsugu Umeda MD Tomonari Awaya MD Yoshihiro Yui MD Akira Niwa MD Hisanori Fujino MD Hiroshi Matsubara MD Ken‐Ichiro Watanabe MD Toshio Heike MD Naoto Adachi MD Fumio Endo MD Tomoyuki Mizukami MD Hiroyuki Nunoi MD Tatsutoshi Nakahata MD Souichi Adachi MD |
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| Affiliation: | 1. Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan;2. Department of Pediatrics, Graduate School of Medicine, Kumamoto University, Kumamoto, Japan;3. Faculty of Medicine, Department of Pediatrics, University of Miyazaki, Miyazaki, Japan |
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| Abstract: | A 6‐year‐old male with chronic granulomatous disease, who was transplanted with bone marrow and exhibited increasing mixed chimerism, subsequently received two donor lymphocyte infusions (DLI). Two weeks after the second DLI, the patient developed acute graft‐versus‐host disease (GVHD) and progressive pancytopenia that was associated with autoantibody production. Conventional treatment did not improve the pancytopenia. However, administration of Rituximab (RTX) (375 mg/m2/week for four consecutive weeks) resulted in a rapid resolution of the pancytopenia. The patient achieved full donor chimerism without GVHD symptoms. RTX can be valuable for managing immune‐mediated cytopenias that arise after DLI and are refractory to conventional therapies. Pediatr Blood Cancer 2010;54:329–331. © 2009 Wiley‐Liss, Inc. |
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| Keywords: | allogeneic stem cell transplantation antibodies graft rejection graft‐versus‐host disease immune responses Rituximab |
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