Treatment of chronic steroid-refractory graft-versus-host disease with low-dose rituximab.
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.
von Bonin
Malte
M
Medizinische Klinik und Poliklinik I, University hospital Carl-Gustav-Carus, Fetscherstrasse, Dresden, Germany.
Oelschlägel
Uta
U
Radke
Jörgen
J
Stewart
Michelle
M
Ehninger
Gerhard
G
Bornhauser
Martin
M
Platzbecker
Uwe
U
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
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