Prior rituximab correlates with less acute graft-versus-host disease and better survival in B-cell lymphoma patients who received allogeneic peripheral blood stem cell transplantation

• Type of Material: Article
• Authors: Voravit Ratanatharathorn, Wayne State University; Brent Logan, CIBMTR; Dan Wang, CIBMTR; Mary Horowitz, CIBMTR; Joseph P. Uberti, Wayne State University; Olle Ringden, Karolinska University Hospital; Robert Peter Gale, Celgene; Hanna Khoury, Emory University; Mukta Arora, University of Minnesota; Stephen Spellman, CIBMTR; Corey Cutler, Dana Farber Canc Inst; Joseph Antin, Dana Farber Canc Inst; Martin Bornhaeuser, Tech Univ Dresden; Gregory Hale, St Jude Childrens Hosp; Leo Verdonck, Univ Med Ctr Utrecht; Mitchell Cairo, Columbia University; Vikas Gupta, Princess Margaret Hosp; Pavletic Steven, National Institute of Health
• Language: English
• Date: 2009-06-01
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2009 Blackwell Publishing Ltd.
• Final Published Version (URL): http://dx.doi.org/10.1111/j.1365-2141.2009.07674.x
• Title of Journal or Parent Work: British Journal of Haematology
• ISSN: 0007-1048
• Volume: 145
• Issue: 6
• Start Page: 816
• End Page: 824
• Keywords: LOW-GRADE; graft-versus-host disease; rituximab; lymphoma; DEPLETING THERAPY; CYCLOSPORINE; allogeneic; COMPARING METHOTREXATE; Hematology; FOLLICULAR LYMPHOMA; MARROW-TRANSPLANTATION; MONOCLONAL-ANTIBODY TREATMENT; NON-HODGKINS-LYMPHOMA; IN-VIVO; IDIOPATHIC THROMBOCYTOPENIC PURPURA; Science & Technology; transplantation; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Oncology; Health Sciences, Immunology

Abstract

Prior therapy with rituximab might attenuate disparate histocompatibility antigen presentation by B cells, thus decreased the risk of acute graft-versus-host disease (GVHD) and improved survival. We tested this hypothesis by comparing the outcomes of 435 B-cell lymphoma patients who received allogeneic transplantation from 1999 to 2004 in the Center for International Blood and Marrow Transplant Research database: 179 subjects who received rituximab within 6 months prior to transplantation (RTX cohort) and 256 subjects who did not receive RTX within 6 months prior to transplantation (No-RTX cohort). The RTX cohort had a significantly lower incidence of treatment-related mortality (TRM) [relative risk (RR) = 0·68; 95% confidence interval (CI), 0·47-1·0; P = 0·05], lower acute grade II-IV (RR = 0·72; 95% CI, 0·53-0·97; P = 0·03) and III-IV GVHD (RR = 0·55; 95% CI, 0·34-0·91; P = 0·02). There was no difference in the risk of chronic GVHD, disease progression or relapse. Progression-free survival (PFS) (RR = 0·68; 95% CI 0·50-0·92; P = 0·01) and overall survival (OS) (RR = 0·63; 95% CI, 0·46-0·86; P = 0·004) were significantly better in the RTX cohort. Prior RTX therapy correlated with less acute GVHD, similar chronic GVHD, less TRM, better PFS and OS.