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