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Blood, 15 October 2004, Vol. 104, No. 8, pp. 2603-2606.
Prepublished online as a Blood First Edition Paper on July 13, 2004; DOI 10.1182/blood-2004-05-1855.
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TRANSPLANTATION Brief report
Anti-CD20 monoclonal antibody treatment in 6 patients with therapy-refractory chronic graft-versus-host disease
Marijke R. Canninga-van Dijk,
Hanneke M. van der Straaten,
Rob Fijnheer,
Cornelus J. Sanders,
Jan G. van den Tweel, and
Leo F. Verdonck
From the Departments of Pathology, Hematology, and Dermatology, University Medical Centre Utrecht (UMCU), The Netherlands.
Chronic graft-versus-host disease (cGVHD) is an important determinant of long-term morbidity and mortality in allogeneic stem cell transplantation patients. Because cGVHD has clinical, histologic, and laboratory findings of autoimmune diseases and antiB-cell therapy has shown efficacy in autoimmune diseases, we hypothesized that monoclonal anti-CD20 antibody therapy might improve patients with cGVHD. We treated 5 men and 1 woman with therapy-refractory extensive cGVHD with anti-CD20 monoclonal antibody. Intravenous infusion was given at a weekly dose of 375 mg/m2 for 4 weeks. In case of incomplete clinical response, additional courses of 4 weeks were given. Five patients responded to treatment with marked clinical, biochemical, and histologic improvement. One patient failed to respond. Anti-CD20 monoclonal antibody seems to be effective in cGVHD. A controlled trial is mandatory to confirm these results. The outcome of this study suggests a participating role of B cells in the pathogenesis of cGVHD.

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