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Rituximab for the treatment of corticosteroid-refractory chronic graft-versus-host disease

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Abstract

We prospectively evaluated the safety and efficacy of the anti-CD20 chimeric monoclonal antibody rituximab for the treatment of corticosteroid-refractory chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation. Seven patients were treated with 375 mg/m2 rituximab weekly for 4 consecutive weeks. Rituximab was well tolerated with no severe toxicity observed during treatment. At 1 year, 3 patients showed a partial response to rituximab therapy, 3 had stable disease, and 1 had progressive disease. Rituximab allowed a reduction in the dose of steroids in 4 patients. Responsive manifestations included mild to moderate skin and oral lesions, and immune hemolytic anemia, and thrombocytopenia. Severe manifestations involving the skin, fascia, and eye did not respond to treatment. These observations suggest that rituximab therapy may be effective for select patients with corticosteroid-refractory chronic GVHD that is not advanced.

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Acknowledgments

This study was supported by the Health and Labor Science Research Grants (Tokyo, Japan) (to T.T.), and a grant from the Foundation for Promotion of Cancer Research (Tokyo, Japan) (to T.T.).

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Authors and Affiliations

  1. Center for Cellular and Molecular Medicine, Kyushu University Graduate School of Medical Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Takanori Teshima, Toshihiro Miyamoto & Koichi Akashi

  2. Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Koji Nagafuji, Toshihiro Miyamoto, Katsuto Takenaka, Koichi Akashi & Mine Harada

  3. Department of Hematology, Hamanomachi General Hospital, Fukuoka, Japan

    Hideho Henzan & Ken Takase

  4. Department of Hematology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan

    Koichi Miyamura

  5. Department of Internal Medicine, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan

    Michihiro Hidaka

Authors
  1. Takanori Teshima
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  2. Koji Nagafuji
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  3. Hideho Henzan
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  4. Koichi Miyamura
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  5. Ken Takase
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  6. Michihiro Hidaka
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  7. Toshihiro Miyamoto
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  8. Katsuto Takenaka
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  9. Koichi Akashi
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  10. Mine Harada
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Correspondence to Takanori Teshima.

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Teshima, T., Nagafuji, K., Henzan, H. et al. Rituximab for the treatment of corticosteroid-refractory chronic graft-versus-host disease. Int J Hematol 90, 253–260 (2009). https://doi.org/10.1007/s12185-009-0370-x

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  • DOI: https://doi.org/10.1007/s12185-009-0370-x

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