All content on this site is intended for healthcare professionals only. By acknowledging this message and accessing the information on this website you are confirming that you are a Healthcare Professional.

The GvHD Hub uses cookies on this website. They help us give you the best online experience. By continuing to use our website without changing your cookie settings, you agree to our use of cookies in accordance with our updated Cookie Policy

Introducing

Now you can personalise
your GvHD Hub experience!

Bookmark content to read later

Select your specific areas of interest

View content recommended for you

Find out more
  TRANSLATE

The GvHD Hub website uses a third-party service provided by Google that dynamically translates web content. Translations are machine generated, so may not be an exact or complete translation, and the GvHD Hub cannot guarantee the accuracy of translated content. The GvHD Hub and its employees will not be liable for any direct, indirect, or consequential damages (even if foreseeable) resulting from use of the Google Translate feature. For further support with Google Translate, visit Google Translate Help.

Steering CommitteeAbout UsNewsletterContact
LOADING
You're logged in! Click here any time to manage your account or log out.
LOADING
You're logged in! Click here any time to manage your account or log out.

The GvHD Hub is an independent medical education platform, sponsored by Medac and supported through grants from Sanofi and Therakos. The funders are allowed no direct influence on our content. The levels of sponsorship listed are reflective of the amount of funding given. View funders.

2024-02-09T15:12:13.000Z

Safety and efficacy of low-dose rituximab in steroid-refractory cGvHD

Feb 9, 2024
Share:
Learning objective: After reading this article, learners will be able to cite a new clinical development in steroid refractory chronic graft-versus-host disease.

Bookmark this article

Currently, there is no one standard of care for first-line treatment of patients with chronic graft-versus-host disease (cGvHD) who do not respond to steroids.1 There is evidence to support the use of rituximab, a chimeric anti-CD20 antibody (when administrated weekly at a dose of 375 mg/ m2), as an adequate treatment option; however, it is not cost-effective.1

Here, we summarize key findings by Colunga-Pedraza et al.1 in Transplant Immunology on the use of low-dose rituximab in steroid-refractory cGvHD (SR-cGvHD).

Study design1

  • In total, 26 patients with SR-cGvHD, who had received low-dose rituximab (100 mg weekly for 4 weeks) were included for analysis
  • cGvHD was classified as per the 2014 National Institutes of Health criteria
  • SR-cGvHD was categorized as cGvHD progression while on prednisone ≥ 1 mg/kg/day for 1–2 weeks or stable cGvHD while on ≥0.5 mg/kg/day for 1–2 months
  • Overall, 13 patients received rituximab for ≤31 days from the commencement of cGvHD therapy

Key findings1

Table 1. Overall survival in patients with and without rituximab treatment*

Overall survival, %

1-year

2-years

3-years

Among patients with cGvHD

83

78

58

Among patients with cGvHD following rituximab

81

78

60

cGvHD, chronic graft-versus-host-disease; OS, overall survival.
*Adapted from Colunga-Pedraza, et al.1

  • The overall response rate for patients treated with low-dose rituximab was 92%
  • Overall, 1-year event-free survival was achieved in 70% of patients
  • The occurrence of progression/relapse within 1-year was observed at a rate of 25%
  • By the end of the study period, 27% of patients did not have a recurrence of GvHD
  • In total, 58% of patients experienced adverse events, with Grade 1 and 2 infections being the most common (46%)
Key learnings1
  • Low-dose rituximab was found to be as safe and effective as using the more commonly used, higher dose, for the treatment of SR-cGvHD.
  • Using a lower dose of rituximab is a cost-effective alternative for the treatment of patients with SR-cGvHD.

  1. Colunga-Pedraza PR, Barbosa-Castillo LM, Coronado-Alejandro EU, et al. Low-dose rituximab in steroid-refractory chronic graft-versus-host disease. Transplant Immunol. 2023;81:10195 DOI:10.1016/j.trim.2023.101959

Newsletter

Subscribe to get the best content related to GvHD delivered to your inbox