title: Effect of anti-CD 20 antibody rituximab in patients with post-transplant lymphoproliferative disorder (PTLD).
abstract: Post-transplant lymphoproliferative disorders (PTLD) are a life-threatening complication following solid organ transplantation. Treatment with rituximab, a humanized anti-CD20 monoclonal antibody, has proved to be a promising approach and shown a low toxicity profile. Between February 1999 and April 2002, we conducted a multicentre phase II trial investigating rituximab as single agent in 17 patients with PTLD. Transplanted organs were heart (n = 5), kidney (n = 4), lung (n = 4) and liver (n = 4). Patients were treated with four weekly doses of 375 mg/m(2) of rituximab. The mean follow-up time is 24.2 months. Histology was distributed in 10 diffuse large cell-, 2 marginal zone-, 1 Burkitt-like lymphoma, 1 Hodgkin-like PTLD and 3 polymorphic lymphoproliferations. Therapy was well tolerated and no severe adverse events were observed. The mean overall survival period is 37.0 months with 11 patients still living. In total, 9 patients (52.9%) achieved a complete remission, with a mean duration of 17.8 months. Partial remission was observed in 1 patient, minor remission in 2 patients, no change in 3 patients and 1 patient experienced progressive disease. Two patients relapsed, at intervals 3 and 5 months after obtaining complete remission. Rituximab proved to be well tolerated and effective in the treatment of PTLD.
authors.affiliation: University Medicine of Berlin, Charite-Campus Virchow Clinic, Department of Internal Medicine, Berlin, Germany. stephan.oertel@charite.de
authors.forename: S H K
authors.initials: SH
authors.lastname: Oertel
authors.forename: E
authors.initials: E
authors.lastname: Verschuuren
authors.forename: P
authors.initials: P
authors.lastname: Reinke
authors.forename: K
authors.initials: K
authors.lastname: Zeidler
authors.forename: M
authors.initials: M
authors.lastname: Papp-Váry
authors.forename: N
authors.initials: N
authors.lastname: Babel
authors.forename: R U
authors.initials: RU
authors.lastname: Trappe
authors.forename: S
authors.initials: S
authors.lastname: Jonas
authors.forename: M
authors.initials: M
authors.lastname: Hummel
authors.forename: I
authors.initials: I
authors.lastname: Anagnostopoulos
authors.forename: B
authors.initials: B
authors.lastname: Dörken
authors.forename: H B
authors.initials: HB
authors.lastname: Riess
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000276:immunology*; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D016030:Kidney Transplantation; D016031:Liver Transplantation; D016040:Lung Transplantation; D008232:Lymphoproliferative Disorders / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000276:immunology / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D000069283:Rituximab; D019737:Transplants; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D000970:Antineoplastic Agents; D000069283:Rituximab