title: The immunological phenotype of rituximab-sensitive chronic graft-versus-host disease: a phase II study.
abstract: Chronic graft-versus-host disease is the major long-term complication after allogeneic stem cell transplantation with a suboptimal response rate to current treatments. Therefore, clinical efficacy and changes in lymphocyte subsets before and after rituximab treatment were evaluated in a prospective phase II study in patients with steroid-refractory chronic graft-versus-host disease. Overall response rate was 61%. Only responding patients were found to have increased B-cell numbers prior to treatment. B cells had a naïve-antigen-presenting phenotype and were mainly CD5 negative or had a low CD5 expression. Normal B-cell homeostasis was reestablished in responding patients one year after ritxumab treatment and associated with a significant decline in skin-infiltrating CD8(+) T cells, suggesting that host B cells play a role in maintaining pathological CD8(+) T-cell responses. Imbalances in B-cell homeostasis could be used to identify patients a priori with a higher chance of response to rituximab treatment (Eudra-CT 2008-004125-42).
authors.affiliation: Department of Immunology, UMC Utrecht, Utrecht, The Netherlands.
authors.forename: Suzanne
authors.initials: S
authors.lastname: van Dorp
authors.forename: Henrike
authors.initials: H
authors.lastname: Resemann
authors.forename: Liane
authors.initials: L
authors.lastname: te Boome
authors.forename: Floor
authors.initials: F
authors.lastname: Pietersma
authors.forename: Debbie
authors.initials: D
authors.lastname: van Baarle
authors.forename: Frits
authors.initials: F
authors.lastname: Gmelig-Meyling
authors.forename: Roel
authors.initials: R
authors.lastname: de Weger
authors.forename: Eefke
authors.initials: E
authors.lastname: Petersen
authors.forename: Monique
authors.initials: M
authors.lastname: Minnema
authors.forename: Henk
authors.initials: H
authors.lastname: Lokhorst
authors.forename: Saskia
authors.initials: S
authors.lastname: Ebeling
authors.forename: Scott J P
authors.initials: SJ
authors.lastname: Beijn
authors.forename: Edward F
authors.initials: EF
authors.lastname: Knol
authors.forename: Marijke
authors.initials: M
authors.lastname: van Dijk
authors.forename: Ellen
authors.initials: E
authors.lastname: Meijer
authors.forename: Jürgen
authors.initials: J
authors.lastname: Kuball
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000276:immunology; D002908:Chronic Disease; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology*; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D016130:Immunophenotyping; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008212:Lymphocyte Depletion; D010641:Phenotype; D011379:Prognosis; D000069283:Rituximab; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007166:Immunosuppressive Agents; D000069283:Rituximab