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Lack of efficacy of rituximab in refractory sclerodermatous chronic GVHD

Bone Marrow Transplantation volume 47, pages 737–738 (2012)Cite this article

Advances in the understanding of cGVHD have implicated B lymphocytes in its pathophysiology.1 A number of studies have explored the use of the antiCD20 MoAb rituximab in the treatment of patients with steroid-refractory cGVHD. These studies yielded varying findings regarding organ-specific responses. Data on cutaneous cGVHD are available from two prospective studies and four retrospective studies involving a total of 67 patients so far. In a recent review and meta-analysis, Mohamed et al.1 reported that responses were impressive in cases of sclerodermatous or lichenoid cutaneous cGVHD. We detail our experience with the use of rituximab in sclerodermatous GVHD, which is different from that reported previously.

We retrospectively reviewed the medical records of patients with steroid-refractory cutaneous cGVHD treated with rituximab. Patients were treated with rituximab 375 mg/m2 weekly for three to four doses. Determination of response was based on the records of the clinician and whether additional immunosuppressive agents were added after rituximab therapy for non-response or progression of disease. We followed the response criteria given by Zaja et al.:2 CR in case of complete resolution of cGVHD manifestations; PR in cases of 50% or more regression of cGVHD manifestations; no response (NR) less than 50% improvement, or exacerbation during or after therapy.

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References

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Authors and Affiliations

  1. Department of Dermatology, Westmead Hospital, Sydney, New South Wales, Australia

    L George & P Fernandez-Peñas

  2. Department of Haematology, Westmead Hospital, Sydney, New South Wales, Australia

    B George, D J Gottlieb & M Hertzberg

  3. Sydney Medical School Westmead, The University of Sydney, Sydney, New South Wales, Australia

    D J Gottlieb, M Hertzberg & P Fernandez-Peñas

Authors
  1. L George
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  2. B George
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  3. D J Gottlieb
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  4. M Hertzberg
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  5. P Fernandez-Peñas
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Correspondence to P Fernandez-Peñas.

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The authors declare no conflict of interest.

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George, L., George, B., Gottlieb, D. et al. Lack of efficacy of rituximab in refractory sclerodermatous chronic GVHD. Bone Marrow Transplant 47, 737–738 (2012). https://doi.org/10.1038/bmt.2011.150

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