In vivo B-cell depletion with rituximab for alternative donor hemopoietic SCT (original) (raw)

Graft-Versus-Host Disease

Bone Marrow Transplantation volume 47, pages 101–106 (2012)Cite this article

Abstract

We retrospectively analyzed 55 patients given a fixed dose of rituximab (200 mg) on day+5 after an alternative donor transplant, to prevent EBV DNA-emia; 68 alternative transplants who did not receive prophylactic rituximab served as controls. The two groups were comparable for donor type, and all patients received anti-thymocyte globulin in the conditioning regimen. Rituximab patients had a significantly lower rate of EBV DNA-emia 56 vs 85% (_P_=0.0004), a lower number of maximum median EBV copies (91 vs 1321/105 cells, _P_=0.003) and a significantly lower risk of exceeding 1000 EBV copies per 105cells (14 vs 49%, _P_=0.0001). Leukocyte and lymphocyte counts were lower on day +50 and+100 in rituximab patients, whereas Ig levels were comparable. The cumulative incidence of grade II–IV acute GvHD was significantly reduced in rituximab patients (20 vs 38%, _P_=0.02). Chronic GvHD was comparable. There was a trend for a survival advantage for patients receiving rituximab (46 vs 40%, _P_=0.1), mainly because of lower transplant mortality (25 vs 37%, _P_=0.1). Despite the drawback of a retrospective study, these data suggest that a fixed dose of rituximab on day +5 reduces the risk of a high EBV load, and also reduces acute GvHD.

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Acknowledgements

This work was partly supported by the Associazione Italiana Ricerca contro il Cancro (AIRC) Milano and Fondazione Ricerca Trapianto Midollo Osseo (FARITMO) Genova.

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Authors and Affiliations

  1. Divisione Ematologia e Trapianto di Midollo Osseo, Ospedale San Martino, Genova, Italy
    A Dominietto, E Tedone, M Soracco, B Bruno, A M Raiola, M T Van Lint, S Geroldi, T Lamparelli, B Galano, F Gualandi, F Frassoni & A Bacigalupo

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  1. A Dominietto
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  2. E Tedone
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  3. M Soracco
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  4. B Bruno
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  5. A M Raiola
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  6. M T Van Lint
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  7. S Geroldi
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  8. T Lamparelli
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  9. B Galano
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  10. F Gualandi
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  11. F Frassoni
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  12. A Bacigalupo
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Correspondence toA Bacigalupo.

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Dominietto, A., Tedone, E., Soracco, M. et al. In vivo B-cell depletion with rituximab for alternative donor hemopoietic SCT.Bone Marrow Transplant 47, 101–106 (2012). https://doi.org/10.1038/bmt.2011.28

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