BMT Tandem Meetings | Rituximab first-line therapy for chronic GvHD

Data was presented at the 2018 BMT Tandem Meetings in Salt Lake City, Utah regarding rituximab as first-line treatment in cGVHD. The study was led by Connie Sizemore of Northside Hospital in Atlanta, Georgia. Patients in the study continued to receive standard immunosuppression agents, but only short course steroid therapy was permitted. 

Key Findings:

• N = 95 patients
• Median age = 55 years (range 24 to 75 years)
• NIH cGVHD grading
  • Mild = 6%
  • Moderate = 42%
  • Severe = 52%
• Median number of GVHD sites involved = 4 (range 1 to 7)
• GVHD sites involved
  • Mouth = 84%
  • Skin = 77%
  • Eyes = 74%
  • Upper GI = 44%
  • Liver = 40%
• Quiescence and taper of immunosuppression = 72.6%
• Three-year resolution of cGVHD = 71%
• Two-year overall survival = 80%
• Two-year non-relapse mortality = 15%
• Overall incidence of recurrent GVHD = 15%

This study shows that rituximab is a promising therapy choice for providing favorable clinical outcomes, while minimizing adverse events of high dose steroid therapy. Further study is warranted in a larger population, as well as determination of prognostic factors predicting which patients are at highest risk of GVHD relapse with rituximab therapy.