Treatment of chronic graft-versus-host disease with anti-CD20 chimeric monoclonal antibody

Voravit Ratanatharathorn, Lois Ayash, Christopher Reynolds, Samuel Silver, Pavan Reddy, Michael Becker, James L.M. Ferrara, Joseph P. Uberti

Research output: Contribution to journalArticlepeer-review

199 Scopus citations

Abstract

We reviewed the clinical outcome of 8 patients with steroid-refractory chronic graft-versus-host disease (GVHD) who received an anti-CD20 chimeric monoclonal antibody (rituximab). Rituximab was given by intravenous infusion at a weekly dose of 375 mg/m2 for 4 weeks. All patients had received extensive treatment with various immunosuppressive agents; 6 patients had also received extracorporeal photopheresis. All patients had extensive chronic GVHD with diffuse or localized sclerodermoid GVHD and xerophthalmia. Other extracutaneous involvements included cold agglutinin disease with the Raynaud phenomenon, membranous glomerulonephritis, and restrictive or obstructive lung disease. Four patients responded to treatment with ongoing resolution or improvement ranging from 265 to 846 days after therapy, despite recovery of B cells in 3 patients. Rituximab seems to have significant activity in the treatment of refractory chronic GVHD and should be considered for further study in patients with early disease. This study suggests a participating role of B cells in the pathogenesis of chronic GVHD.

Original languageEnglish
Pages (from-to)505-511
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume9
Issue number8
DOIs
StatePublished - Aug 2003
Externally publishedYes

Keywords

  • Acute graft-versus-host disease
  • Allogeneic transplantation
  • Anti-CD20 antibody
  • B-cell depletion
  • Chronic graft-versus-host disease
  • Hematopoietic stem cell transplantation

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