title: Treatment of refractory chronic GVHD with rituximab: a GITMO study.
abstract: The anti-CD20 chimaeric monoclonal antibody Rituximab has recently been shown to induce significant clinical response in a proportion of patients with refractory chronic graft-versus-host disease (cGVHD). We now report 38 patients, median age 48 years (22-61), receiving Rituximab for refractory cGVHD, assessed for clinical response and survival. Median duration of cGVHD before Rituximab was 23 months (range 2-116), the median number of failed treatment lines was 3 (range 1 to > or =6) and the median follow-up after Rituximab was 11 months (1-88). Overall response rate was 65%: skin 17/20 (63%), mouth 10/21 (48%), eyes 6/14 (43%), liver 3/12 (25%), lung 3/8 (37.5%), joints 4/5, gut 3/4, thrombocytopaenia 2/3, vagina 0/2, pure red cell aplasia 0/1 and, myasthenia gravis 1/1. During the study period 8/38 died: causes of death were cGVHD progression (n=3), disease relapse (n=1), infection (n=3), sudden death (n=1). The actuarial 2 year survival is currently 76%. We confirm that Rituximab is effective in over 50% of patients with refractory cGVHD and may have a beneficial impact on survival.
authors.affiliation: Clinica Ematologica DIRM, Azienda Ospedaliera Universitaria, Udine, Italy. francesco.zaja@med.uniud.it
authors.forename: F
authors.initials: F
authors.lastname: Zaja
authors.forename: A
authors.initials: A
authors.lastname: Bacigalupo
authors.forename: F
authors.initials: F
authors.lastname: Patriarca
authors.forename: M
authors.initials: M
authors.lastname: Stanzani
authors.forename: M T
authors.initials: MT
authors.lastname: Van Lint
authors.forename: C
authors.initials: C
authors.lastname: Filì
authors.forename: R
authors.initials: R
authors.lastname: Scimè
authors.forename: G
authors.initials: G
authors.lastname: Milone
authors.forename: M
authors.initials: M
authors.lastname: Falda
authors.forename: C
authors.initials: C
authors.lastname: Vener
authors.forename: D
authors.initials: D
authors.lastname: Laszlo
authors.forename: P E
authors.initials: PE
authors.lastname: Alessandrino
authors.forename: F
authors.initials: F
authors.lastname: Narni
authors.forename: S
authors.initials: S
authors.lastname: Sica
authors.forename: A
authors.initials: A
authors.lastname: Olivieri
authors.forename: A
authors.initials: A
authors.lastname: Sperotto
authors.forename: A
authors.initials: A
authors.lastname: Bosi
authors.forename: F
authors.initials: F
authors.lastname: Bonifazi
authors.forename: R
authors.initials: R
authors.lastname: Fanin
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D058846:Antibodies, Monoclonal, Murine-Derived; D002908:Chronic Disease; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality*; D019337:Hematologic Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000069283:Rituximab; D033581:Stem Cell Transplantation; D015996:Survival Rate
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab