title: Combination treatment of bullous pemphigoid with anti-CD20 and anti-CD25 antibodies in a patient with chronic graft-versus-host disease.
abstract: In this case report we describe a novel treatment with two chimeric monoclonal antibodies (MoAb) targeting the autoimmune B cell clone responsible for bullous pemphigoid (BP) as a manifestation of steroid refractory chronic graft-versus-host disease (GVHD) that developed after unrelated cord blood transplantation. Monitoring the BP-specific circulating antibodies and CD25-expressing activated T lymphocyte subset led us to combine anti-CD20 (Rituximab) mediated B cell ablation with anti-CD25 (Daclizumab) therapy to block CD4(+) T cell help. Complete clinical and serologic response was achieved within 4 weeks of initiation of therapy allowing global immunosuppression to be dramatically reduced.
authors.affiliation: Department of Pediatrics, Pediatric Stem Cell Transplant Program, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: P
authors.initials: P
authors.lastname: Szabolcs
authors.forename: M
authors.initials: M
authors.lastname: Reese
authors.forename: K B
authors.initials: KB
authors.lastname: Yancey
authors.forename: R P
authors.initials: RP
authors.lastname: Hall
authors.forename: J
authors.initials: J
authors.lastname: Kurtzberg
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000627:therapeutic use; D018951:Antigens, CD20 / Q000276:immunology; D001402:B-Lymphocytes / Q000187:drug effects / Q000473:pathology; D002648:Child; D002908:Chronic Disease; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects; D004359:Drug Therapy, Combination; D006086:Graft vs Host Disease / Q000188:drug therapy*; D006801:Humans; D008297:Male; D010391:Pemphigoid, Bullous / Q000188:drug therapy*; D015375:Receptors, Interleukin-2 / Q000276:immunology; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D018951:Antigens, CD20; D015375:Receptors, Interleukin-2