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Safety and efficacy of rituximab-based first line treatment of chronic GVHD

Bone Marrow Transplantation volume 54, pages 1218–1226 (2019)Cite this article

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Abstract

Initial therapy of chronic GVHD (cGvHD) has not changed for over three decades, despite limited efficacy and long-term toxicity. We have previously shown in a small pilot study the feasibility of rituximab-based first-line therapy of cGVHD. To better assess safety and efficacy, we now evaluate 69 patients that received rituximab as part of their initial treatment. Median follow-up for surviving patients was 47 (11–81) months. Resolution of cGVHD occurred in 49 patients with median time to IST discontinuation of 349 (138–920) days. The cumulative incidence (CI) of cGHVD resolution was 41%, 69 and 77% at 1-, 2- and 3-years, respectively. No systemic corticosteroids were used in 27 patients, and 67% received ≤ 10 mg/kg cumulative exposure. Overall survival (OS) at 1-, 2- and 3-years following cGVHD diagnosis was 87, 79 and 77% respectively; corresponding rates of non-relapse mortality (NRM) were 10%, 16 and 19%. The probability of being alive and free of cGVHD at 1-, 2-, and 3-years was 36, 55, and 57% respectively. This study demonstrates the feasibility and efficacy of rituximab-based first-line cGVHD treatment. This approach demonstrates significant activity and avoids long courses of corticosteroids in most patients.

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Authors and Affiliations

  1. The Blood and Marrow Transplant Program at Northside Hospital, Atlanta, GA, USA

    Scott R. Solomon, Connie A. Sizemore, Michelle Ridgeway, Stacey Brown, H. Kent Holland, Lawrence E. Morris, Melhem Solh & Asad Bashey

  2. The University of Texas, Health Science Center at Houston, Houston, TX, USA

    Xu Zhang

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Solomon, S.R., Sizemore, C.A., Ridgeway, M. et al. Safety and efficacy of rituximab-based first line treatment of chronic GVHD. Bone Marrow Transplant 54, 1218–1226 (2019). https://doi.org/10.1038/s41409-018-0399-7

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