Chimaeric anti‐CD20 monoclonal antibody (rituximab) in post‐transplant B‐lymphoproliferative disorder following stem cell transplantation in children

British Journal of Haematology - Tập 115 Số 1 - Trang 112-118 - 2001
Albert Faye1, Pierre Quartier2, Yves Réguerre3, Patrick Lutz4, Anne‐Sophie Carret5, Axelle Dehée6, Pierre Bordigoni1, Michel Peuchmaur7, Anne Matthieu‐Boué8, Alain Fischer2, E Vilmer1
1Service d'hémato‐immunologie, Hôpital Robert Debré,
2Service d'immuno-hématologie, Hôpital Necker-Enfants Malades,
3Service d’Hématologie, Hôpital Saint Louis, Paris
4Service d'hématologie, Hôpital Universitaire de Hautepierre, Strasbourg,
5Service d'hématologie, Hôpital Universitaire de Nancy, Nancy,
6Laboratoire de virologie, EA 2391, 
Hôpital Armand Trousseau,
7Laboratoire d'anatomopathologie, Hôpital Robert Debré, Paris, and
8Produits Roche, France

Tóm tắt

Post‐transplant lymphoproliferative disorder (PTLD) after haemopoietic stem cell transplantation is a serious complication that occurs in 8–22% of patients with high‐risk factors. We retrospectively investigated tolerance and efficacy of humanized anti‐CD20 monoclonal antibody (rituximab) as first‐line treatment in 12 children with B‐cell PTLD. At diagnosis, eight patients had tumoral involvement. The other four patients had fever, associated with raised Epstein–Barr virus (EBV) viral load and monoclonal gammopathy. Rituximab was given at the dose of 375 mg/m2 once a week by intravenous infusion (1–9 infusions). Only 1/48 infusions was associated with a grade 2 clinical adverse event. Eight out of 12 (66%) patients responded to the treatment and were in complete remission. All patients without tumoral involvement responded to the treatment. A rapid decrease in fever within 1 week was observed in all responders. Non‐responders did not show any clinical response during the first week. Tumoral involvement and immunodepression seemed to be more marked in non‐responders. Rituximab was an effective and well‐tolerated treatment of B‐cell PTLD. Early treatment before tumoral involvement seemed to be the most effective approach. Lack of rapid response should lead to intensification of PTLD treatment. Pre‐emptive treatment should be considered and evaluated in further longitudinal multicentre studies.

Từ khóa


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Thông tin
Thông tin xuất bản

British Journal of Haematology

Tập 115 Số 1

112-118

Thông tin tác giả