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Successful anti-CD20 antibody treatment of pemphigus foliaceus after unrelated cord blood transplantation

Bone Marrow Transplantation volume 35, pages 427–428 (2005)Cite this article

In a paper published in this journal, Szabolcs et al1 reported the unusual case of a young boy who experienced bullous pemphigoid in association with chronic graft-versus-host disease (GVHD) after unrelated cord blood transplantation. Successful treatment was achieved by the combination of anti-CD25 and anti-CD20 antibodies along with steroids and other immunosuppressive agents. Pemphigus foliaceus (PF) is also an immune-mediated skin disease and is also unusual after hematopoietic stem cell transplantation (HSCT), as there is no report to date of PF after HSCT. We report here a case of PF after unrelated cord blood transplantation, successfully treated with anti-CD20 antibody.

A 6-year old boy with Philadelphia chromosome-positive B-lineage acute lymphoblastic leukemia in first complete remission received an HLA-mismatched unrelated cord blood transplant in July 2002. The conditioning regimen consisted of fractionated total body irradiation (total dose 1200 cGy), etoposide (60 mg/kg) and cyclophosphamide (3600 mg/m2). Cyclosporine, rabbit antithymocyte globulin (Thymoglobuline, Sangstat, CA, USA, total dose 8 mg/kg) and methylprednisolone (2 mg/kg/day from day −2, tapering beginning on day +20) were given as prophylaxis for GVHD. Donor and recipient differed for one B and one DRB1 allele.

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Authors and Affiliations

  1. Division of Hematology-Oncology, Department of Paediatrics, Hôpital Sainte-Justine, 3175, chemin de la Côte-Sainte-Catherine, Montréal, Québec, Canada, H3T 1C5

    A L Herr, J H Dalle, M A Champagne & M Duval

  2. Department of Dermatology, Hôpital Sainte-Justine, Université de Montréal, Montréal, Canada

    A Hatami

  3. Department of Pathology, Hôpital Sainte-Justine, Université de Montréal, Montréal, Canada

    V Kokta

  4. Centre de Recherche, Hôpital Sainte-Justine, Université de Montréal, Montréal, Canada

    J H Dalle, M A Champagne & M Duval

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  1. A L Herr
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Herr, A., Hatami, A., Kokta, V. et al. Successful anti-CD20 antibody treatment of pemphigus foliaceus after unrelated cord blood transplantation. Bone Marrow Transplant 35, 427–428 (2005). https://doi.org/10.1038/sj.bmt.1704808

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