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Rituximab is effective for steroid-refractory sclerodermatous chronic graft-versus-host disease

Leukemia volume 20, pages 172–173 (2006)Cite this article

Chronic graft-versus-host disease (GVHD) is the most common late complication following allogeneic stem cell transplantation, occurring in 25–80% of transplant recipients.1 It is becoming a more frequent problem due to the increasing recipient age at transplantation as well as the increasing use of alternative donors, peripheral blood stem cells, and donor lymphocyte infusions. The most widely employed first line therapy for chronic GVHD is a combination of cyclosporine (CSA) and prednisolone, but patients who failed to respond to the initial steroid-based therapy have a poor outcome.1 Therefore, various agents have been investigated as salvage therapy for chronic GVHD, but there is no standard approach that is uniformly accepted.

Anti-CD20 antibody (rituximab) is a chimeric mouse–human immunoglobulin G antibody, mediating B-cell lysis by complement-dependent cytotoxicity, antibody-dependent cellular cytotoxicity, and induction of apoptosis. It was developed for the treatment of B-cell malignancies but has also shown efficacy in the treatment of a variety of autoimmune diseases.2 Chronic GVHD has characteristics of not only immunodeficiency but also autoimmunity. A recent report on anti-B-cell therapy with rituximab for thrombocytopenia in a single patient with chronic GVHD showed that apart from the recovery of thrombocytopenia, severe xerostomia of the patient also responded.3

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Authors and Affiliations

  1. Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

    M Okamoto, A Okano, S Akamatsu & C Shimazaki

  2. Division of Blood Transfusion and Cell Therapy, Kyoto University Hospital, Kyoto, Japan

    E Ashihara

  3. Department of Clinical Molecular Genetics and Laboratory Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

    T Inaba

  4. Department of Dermatology, Kyoto Prefectural University of Medicine, Kyoto, Japan

    H Takenaka, N Katoh & S Kishimoto

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  1. M Okamoto
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Okamoto, M., Okano, A., Akamatsu, S. et al. Rituximab is effective for steroid-refractory sclerodermatous chronic graft-versus-host disease. Leukemia 20, 172–173 (2006). https://doi.org/10.1038/sj.leu.2403996

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