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Blood, 15 April 2006, Vol. 107, No. 8, pp. 3053-3057.
Prepublished online as a Blood First Edition Paper on October 27, 2005; DOI 10.1182/blood-2005-01-0377.
 Previous Article | Next Article 
Submitted January 27, 2005
Accepted October 10, 2005
Efficacy and safety of rituximab in B-cell post-transplant lymphoproliferative disorders: results of a prospective multicentre phase II study
Sylvain Choquet*, Veronique Leblond, Raoul Herbrecht, Gerard Socie, Anne-marie Stoppa, Peter Vandenberghe, Alain Fischer, Franck Morschhauser, Gilles Salles, Walter Feremans, Etienne Vilmer, Marie-Noel Peraldi, Philippe Lang, Yvon Lebranchu, Eric Oksenhendler, Jeanne-Luce Garnier, Thierry Lamy, Arnaud Jaccard, Augustin Ferrant, Fritz Offner, Olivier Hermine, Anne Moreau, Samira Fafi-Kremer, Patrice Morand, Lucienne Chatenoud, Nathalie Berriot-Varoqueaux, Loic Bergougnoux, and Noel Milpied
Haematology Unit, La Pitie Salpetriere Hospital, Paris, France
Department of Oncology, Hautepierre Hospital, Strasbourg, France
Department of Haematology and Transplantation, Saint Louis Hospital-INSERM 0220, Paris, France
Hematology Unit, Paoli Calmettes Institute, Marseille, France
Hematology Unit, University Hospital, Leuven, Belgium
Department of Paediatric Immunology and Haematology, Necker Hospital, Paris, France
Department of Haematology, CHU Lille, Lille, France
Department of Hematology, Lyon Sud Hospital EA3737 Claude Bernard Lyon 1 University, Lyon, France
Department of Hematology, Erasme Hospital, Brussels, Belgium
Department of Hematology, Robert Debre Hospital, Paris, France
Nephrology and Transplantation Unit, Necker Hospital, Paris, France
Nephrology and Transplantation Unit, Henri Mondor Hospital, Creteil, France
Nephrology and Transplantation Unit, Bretonneau Hospital, Tours, France
Department of Immunology, Saint-Louis Hospital, Paris, France
Nephrology and Transplantation Unit, Edouard Herriot Hospital, Lyon, France
Department of Hematology, Pontchaillou Hospital, Rennes, France
Department of Hematology, CHU Limoges, Limoges, France
Department of Hematology, Louvain Catholic University, Brussels, Belgium
Department of Hematology, Ziekenhuis University, Gent, Belgium
Department of Hematology, Necker Hospital, Paris, France
Department of Pathology, Hotel Dieu Hospital, Nantes, France
Virology Unit, Albert Michallon Hospital, Grenoble, France
Department of Immunology, Necker Hospital, Paris, France
Roche Laboratories, Neuilly, France
Department of Hematology, Hotel Dieu Hospital, Nantes, France
* Corresponding author; email: sylvain.choquet{at}psl.ap-hop-paris.fr.
B-cell post-transplant lymphoproliferative disorder (B-PTLD) is a rare but severe complication of transplantation, with no consensus on best treatment practice. This prospective trial, the first to test a treatment for PTLD, was designed to evaluate the efficacy and safety of rituximab in patients with B-PTLD after solid organ transplantation (SOT). Forty-six patients were included and 43 patients were analysed. Patients were eligible if they had untreated B-PTLD not responding to tapering of immunosuppression. Treatment consisted of 4 weekly injections of rituximab 375 mg/m2. At d80, 37 (86%) patients were alive, and the response rate was 44.2%, including 12 CR/CRu. The only factor predictive of a response at d80 was a normal lactate dehydrogenase level (p=0.007, OR=6.9). At d360, responses were maintained in 68% of patients, and 56 % of patients were alive. The overall survival rate one year was 67%. We conclude that rituximab is effective and safe in PTLD, with stable responses at 1 year. The response rate and overall survival might be improved by combining rituximab with other treatments.
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