Anti-CD20 antibody (rituximab) administration in patients with late-occurring lymphomas after solid organ transplant

G. Dotti, A. Rambaldi, R. Fiocchi, T. Motta, G. Torre, P. Viero, B. Gridelli, T. Barbui

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Objectives. Aggressive diffuse large cell non-Hodgkin's lymphoma (DLCL) occurring late after a solid organ transplant fails to regress after discontinuation of immunosuppression. Moreover, chemotherapy treatment is associated with a high mortality rate due to severe toxicity. Since the majority of post-transplant lymphoproliferative disorders derive from B-lineage lymphocytes, the administration of anti-B monoclonal antibodies represents a rational therapeutic option. Design and Methods. Five patients who developed CD20-positive DLCL more than two years after heart or liver transplantation were treated with a weekly chemotherapy program (2 patients), radiotherapy (2 patients) and surgery (1 patient) followed by a minimum of 4 intravenous doses of rituximab (375 mg/m2). Results. A favorable clinical outcome was observed in three patients in whom surgery or radiotherapy had produced significant tumor debulking. Only a partial clinical effect was documented in the two patients with advanced clinical stage disease. Interpretation and Conclusions. Rituximab can be safely administered to patients with aggressive CD20-positive DLCL occurring late after a solid organ transplant. However, a positive clinical outcome may be expected only in patients in whom surgery or radiotherapy has achieved significant regression of tumor burden.

Original languageEnglish
Pages (from-to)618-623
Number of pages6
JournalHaematologica
Volume86
Issue number6
Publication statusPublished - 2001

Keywords

  • Allogeneic bone marrow transplant
  • Immunosuppression
  • Immunotherapy
  • PTLD
  • Rituximab
  • Solid organ transplant

ASJC Scopus subject areas

  • Hematology

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