In vivo B-cell depletion with rituximab for alternative donor hemopoietic SCT

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

Research output: Contribution to journalArticlepeer-review

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 10 5 cells (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.

Original languageEnglish
Pages (from-to)101-106
Number of pages6
JournalBone Marrow Transplantation
Volume47
Issue number1
DOIs
Publication statusPublished - Jan 2012

Keywords

  • acute GvHD
  • alternative donors
  • EBV
  • rituximab
  • unrelated

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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