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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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Submitted May 14, 2004
Accepted June 29, 2004
Anti-CD20 monoclonal antibody treatment in six 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
Department of Pathology, University Medical Centre, Utrecht, The Netherlands
Department of Hematology, University Medical Centre, Utrecht, The Netherlands
Department of Dermatology, University Medical Centre, Utrecht, The Netherlands
* Corresponding author; email: M.R.Canningavandijk{at}azu.nl.
Chronic graft-versus-host disease (cGVHD) is an important determinant for long-term morbidity and mortality in allogeneic stem cell transplantation patients. As cGVHD has clinical, histological and laboratory findings of autoimmune diseases and anti-B 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 750 mg 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 histological 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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