title: Allogeneic hematopoietic stem cell transplantation after rituximab-containing myeloablative preparative regimen for acute lymphoblastic leukemia.
abstract: We explored the safety and efficacy of rituximab administered in combination with the standard transplant conditioning regimen of cyclophosphamide (Cy) 120 mg/kg and total body irradiation (TBI) 12 Gy for adult patients with acute lymphoblastic leukemia (ALL). Patients were eligible if their disease expressed CD20. Rituximab was administered at 375 mg/m2 weekly for four doses beginning on day -7 of the conditioning regimen. Graft-versus-host-disease (GVHD) prophylaxis consisted of tacrolimus and methotrexate. Thirty-five patients undergoing matched sibling (n = 23) or unrelated donor (n = 12) transplantation were studied, with a median age of 30 years (range 15-55 years). At 2 years, progression-free survival, treatment-related mortality, and overall survival were 30, 24, and 47%, respectively. There was no delay in engraftment or increased incidence of infection. The cumulative incidence of grade II-IV acute GVHD was 17%, and limited and extensive chronic GVHD was 43% at 2 years. The addition of rituximab to the standard Cy/TBI transplant conditioning regimen in ALL was safe and well tolerated, and there was a suggestion of decreased incidence of acute GVHD when compared to historically reported GVHD rates for this group of patients.
authors.affiliation: Department of Blood and Marrow Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. pkebriae@mdanderson.org
authors.forename: P
authors.initials: P
authors.lastname: Kebriaei
authors.forename: R M
authors.initials: RM
authors.lastname: Saliba
authors.forename: C
authors.initials: C
authors.lastname: Ma
authors.forename: C
authors.initials: C
authors.lastname: Ippoliti
authors.forename: D R
authors.initials: DR
authors.lastname: Couriel
authors.forename: M
authors.initials: M
authors.lastname: de Lima
authors.forename: S
authors.initials: S
authors.lastname: Giralt
authors.forename: M H
authors.initials: MH
authors.lastname: Qazilbash
authors.forename: J L
authors.initials: JL
authors.lastname: Gajewski
authors.forename: C S
authors.initials: CS
authors.lastname: Ha
authors.forename: R E
authors.initials: RE
authors.lastname: Champlin
authors.forename: I F
authors.initials: IF
authors.lastname: Khouri
mesh_terms: D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D002051:Burkitt Lymphoma / Q000628:therapy*; D016009:Chi-Square Distribution; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D008875:Middle Aged; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D000069283:Rituximab; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab