1. In vivo B-cell depletion with rituximab for alternative donor hemopoietic SCT.
- Author
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Dominietto, A, Tedone, E, Soracco, M, Bruno, B, Raiola, A M, Van Lint, M T, Geroldi, S, Lamparelli, T, Galano, B, Gualandi, F, Frassoni, F, and Bacigalupo, A
- Subjects
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RITUXIMAB , *DRUG efficacy , *B cells , *HEMATOPOIETIC stem cell transplantation , *ORGAN donors , *EPSTEIN-Barr virus , *GRAFT versus host disease - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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