title: Treatment of chronic steroid-refractory graft-versus-host disease with low-dose rituximab.
abstract: Rituximab, an anti-CD20 chimeric monoclonal antibody, is widely used in hematologic malignancies and has been introduced as a therapeutic option in autoimmune disorders. In recent studies, rituximab has shown promising activity in steroid-refractory chronic graft-versus-host disease (cGvHD) at a weekly dose of 375 mg/m2. We now report on 13 subjects after peripheral blood stem-cell transplantation receiving low-dose rituximab (50 mg/m2) for steroid-refractory cGvHD and autoimmune disorders (membranous glomerulonephritis and immune thrombocytopenic purpura). The overall response rate was 69%, including two patients with complete responses. In accordance, we observed clearance of peripheral blood B cells even after the first dose of rituximab in four patients. We conclude that low-dose rituximab seems to be active and safe in intensively pretreated patients with steroid-refractory cGvHD.
authors.affiliation: Medizinische Klinik und Poliklinik I, University hospital Carl-Gustav-Carus, Fetscherstrasse, Dresden, Germany.
authors.forename: Malte
authors.initials: M
authors.lastname: von Bonin
authors.forename: Uta
authors.initials: U
authors.lastname: Oelschlägel
authors.forename: Jörgen
authors.initials: J
authors.lastname: Radke
authors.forename: Michelle
authors.initials: M
authors.lastname: Stewart
authors.forename: Gerhard
authors.initials: G
authors.lastname: Ehninger
authors.forename: Martin
authors.initials: M
authors.lastname: Bornhauser
authors.forename: Uwe
authors.initials: U
authors.lastname: Platzbecker
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D015703:Antigens, CD / Q000276:immunology; D018951:Antigens, CD20 / Q000276:immunology; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007938:Leukemia / Q000276:immunology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology* / Q000601:surgery; D000069283:Rituximab
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D015703:Antigens, CD; D018951:Antigens, CD20; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab