|
|
Blood, 15 July 2006, Vol. 108, No. 2, pp. 756-762.
Prepublished online as a Blood First Edition Paper on March 21, 2006; DOI 10.1182/blood-2006-01-0233.
 Previous Article | Next Article 
Submitted January 18, 2006
Accepted March 4, 2006
Rituximab for steroid-refractory chronic graft-vs.-host disease
Corey Cutler*, David Miklos, Haesook T Kim, Nathaniel Treister, Sook-Bin Woo, Don Bienfang, Lloyd B Klickstein, Jesse Levin, Katherine Miller, Carol Reynolds, Rebecca Macdonell, Mildred Pasek, Stephanie J Lee, Vincent Ho, Robert Soiffer, Joseph H Antin, Jerome Ritz, and Edwin Alyea
Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
Department of Medicine, Stanford University, Palo Alto, CA, USA
Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA
Ophthalmology, Brigham and Women's Hospital, Boston, MA, USA
Rheumatology, Brigham and Women's Hospital, Boston, MA, USA
* Corresponding author; email: corey_cutler{at}dfci.harvard.edu.
B cells may be implicated in the pathophysiology of chronic GVHD, as evidenced by antibody production against sex-mismatched, Y chromosome-encoded minor HLA antigens in association with chronic GVHD. We therefore designed a phase I-II study of anti-B cell therapy with rituximab in steroid-refractory chronic GVHD. Twenty-one patients were treated with thirty-eight cycles of rituximab. Rituximab was tolerated well, and toxicity was limited to infectious events. The clinical response rate was 70%, including two patients with complete responses. Responses were limited to patients with cutaneous and musculoskeletal manifestations of chronic GVHD and were durable through one year after therapy. The median dose of prednisone among treated subjects fell from 40 mg/day to 10 mg/day, one year after rituximab therapy (p=0.0001). A chronic GVHD symptom score improved in the majority of treated patients. Antibody titers against Y chromosome-encoded minor HLA antigens fell and remained low while titers against infectious antigens (EBV, tetanus) remained stable or rose during the treatment period. We conclude that specific anti-B cell therapy with rituximab may be beneficial for patients with steroid-refractory chronic GVHD.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
K. Matthews, Z. Lim, B. Afzali, L. Pearce, A. Abdallah, S. Kordasti, A. Pagliuca, G. Lombardi, J. A. Madrigal, G. J. Mufti, et al.
Imbalance of effector and regulatory CD4 T cells is associated with graft-versus-host disease after hematopoietic stem cell transplantation using a reduced intensity conditioning regimen and alemtuzumab
Haematologica,
July 1, 2009;
94(7):
956 - 966.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Daoussis, S.-N. C. Liossis, A. C. Tsamandas, C. Kalogeropoulou, A. Kazantzi, C. Sirinian, M. Karampetsou, G. Yiannopoulos, and A. P. Andonopoulos
Experience with rituximab in scleroderma: results from a 1-year, proof-of-principle study
Rheumatology,
May 15, 2009;
(2009)
kep093v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Sarantopoulos, K. E. Stevenson, H. T. Kim, C. S. Cutler, N. S. Bhuiya, M. Schowalter, V. T. Ho, E. P. Alyea, J. Koreth, B. R. Blazar, et al.
Altered B-cell homeostasis and excess BAFF in human chronic graft-versus-host disease
Blood,
April 16, 2009;
113(16):
3865 - 3874.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Christopeit, V. Schutte, S. Theurich, T. Weber, W. Grothe, and G. Behre
Rituximab reduces the incidence of acute graft-versus-host disease
Blood,
March 26, 2009;
113(13):
3130 - 3131.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. S Bates, A. M. Engemann, and J. M Hammond
Clinical Utility of Rituximab in Chronic Graft-Versus-Host Disease
Ann. Pharmacother.,
February 1, 2009;
43(2):
316 - 321.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Armand, S. Gannamaneni, H. T. Kim, C. S. Cutler, V. T. Ho, J. Koreth, E. P. Alyea, A. S. LaCasce, E. D. Jacobsen, D. C. Fisher, et al.
Improved Survival in Lymphoma Patients Receiving Sirolimus for Graft-Versus-Host Disease Prophylaxis After Allogeneic Hematopoietic Stem-Cell Transplantation With Reduced-Intensity Conditioning
J. Clin. Oncol.,
December 10, 2008;
26(35):
5767 - 5774.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Shimabukuro-Vornhagen, T. Liebig, and M. von Bergwelt-Baildon
Statins inhibit human APC function: implications for the treatment of GVHD
Blood,
August 15, 2008;
112(4):
1544 - 1545.
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Fujii, G. Cuvelier, K. She, S. Aslanian, H. Shimizu, A. Kariminia, M. Krailo, Z. Chen, R. McMaster, A. Bergman, et al.
Biomarkers in newly diagnosed pediatric-extensive chronic graft-versus-host disease: a report from the Children's Oncology Group
Blood,
March 15, 2008;
111(6):
3276 - 3285.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Sarantopoulos, K. E. Stevenson, H. T. Kim, N. S. Bhuiya, C. S. Cutler, R. J. Soiffer, J. H. Antin, and J. Ritz
High Levels of B-Cell Activating Factor in Patients with Active Chronic Graft-Versus-Host Disease
Clin. Cancer Res.,
October 15, 2007;
13(20):
6107 - 6114.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. W. Semple
Rituximab disciplines T cells, spares platelets
Blood,
October 15, 2007;
110(8):
2784 - 2785.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Jacobsohn, A. R. Chen, M. Zahurak, S. Piantadosi, V. Anders, J. Bolanos-Meade, M. Higman, J. Margolis, M. Kaup, and G. B. Vogelsang
Phase II Study of Pentostatin in Patients With Corticosteroid-Refractory Chronic Graft-Versus-Host Disease
J. Clin. Oncol.,
September 20, 2007;
25(27):
4255 - 4261.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Y. Mapara
Stimulating results with stimulatory antibodies
Blood,
July 1, 2007;
110(1):
6 - 7.
[Full Text]
[PDF]
|
|
|
|
|
