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Prepublished online as a Blood First Edition Paper on December 27, 2002; DOI 10.1182/blood-2002-10-3162. This Article Full Text (PDF) All Versions of this Article: 2002-10-3162v1 101/10/3818    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Sansonno, D. Articles by Dammacco, F. Search for Related Content PubMed PubMed Citation Articles by Sansonno, D. Articles by Dammacco, F. Social Bookmarking                   What's this? Submitted October 18, 2002 Accepted December 15, 2002 Treatment of mixed cryoglobulinemia resistant to interferon- with an anti-CD20 monoclonal antibody Domenico Sansonno, Valli De Re, Gianfranco Lauletta, Felicia Anna Tucci, Mauro Boiocchi, and Franco Dammacco* Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Clinical Oncology, University of Bari Medical School, Bari, Italy Division of Experimental Oncology I, Centro di Riferimento Oncologico, Aviano, Italy * Corresponding author; email: dimoclin{at}cimedoc.uniba.it. A controlled study has been carried out to assess the efficacy of rituximab, a chimeric antibody that binds to the B cell surface antigen CD20, in twenty patients with mixed cryoglobulinemia (MC) and HCV-positive chronic active liver disease, resistant to IFN- therapy. They received an intravenous infusion of 375 mg/m2 rituximab once a week for 4 consecutive weeks. Infusion of rituximab had a good safety profile and no severe side-effect was reported. Sixteen patients (80%) showed a complete response (CR), characterized by rapid improvement of clinical signs (disappearance of purpura, weakness arthralgias and improvement of peripheral neuropathy), and decline of cryocrit. CR was associated with a significant reduction of rheumatoid factor (RF) activity and anti-HCV antibody titers. Decline of IgG anti-HCV titers in the cryoprecipitates was usually associated with a favorable response (r = 0.81; p < 0.005). No differences in the dynamics of B-cell depletion and recovery were found between responders and non-responders. Molecular monitoring of the B-cell response revealed disappearance/deletion of peripheral clones in the responders and great stability in the non-responders. Rituximab had a deep impact on hepatitis C viremia: HCV RNA increased approximately twice the baseline levels in the responders, whereas it remained much the same in the non-responders. Twelve out of 16 responders (75%) remained in remission throughout the follow-up. The results indicate that rituximab has clinical and biological activity in HCV-positive MC patients. However, in view of the increased viremia in the responders, additional modes of application and combination of rituximab with other agents need to be investigated. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M P T Lunn and H J Willison Diagnosis and treatment in inflammatory neuropathies Postgrad. Med. J., August 1, 2009; 85(1006): 437 - 446. [Abstract] [Full Text] [PDF] M P T Lunn and H J Willison Diagnosis and treatment in inflammatory neuropathies J. Neurol. Neurosurg. Psychiatry, March 1, 2009; 80(3): 249 - 258. 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