Prospective phase II trial of extended treatment with rituximab in patients with B-cell post-transplant lymphoproliferative disease.


Autoria(s): González-Barca, Eva; Domingo-Domenech, Eva; Capote, Francisco Javier; Gómez-Codina, Jose; Salar, Antonio; Bailen, Alicia; Ribera, Jose-María; López, Andres; Briones, Javier; Muñoz, Andres; Encuentra, Maite; de Sevilla, Alberto Fernández
Data(s)

25/09/2013

25/09/2013

01/11/2007

Resumo

BACKGROUND AND OBJECTIVES The elective treatment of patients with post-transplant lymphoproliferative disorders is controversial. The purpose of this trial was to evaluate the efficacy of treatment with extended doses of rituximab adapted to the response in patients with post-transplant lymphoproliferative disorders after solid organ transplantation. DESIGN AND METHODS This was a prospective, multicenter, phase II trial. Patients were treated with reduction of immunosuppression and four weekly infusions of rituximab. Those patients who did not achieve complete remission (CR) received a second course of four rituximab infusions. The primary end-point of the study was the CR rate. RESULTS Thirty-eight patients were assesable. One episode of grade 4 neutropenia was the only severe adverse event observed. After the first course of rituximab, 13 (34.2%) patients achieved CR, 8 patients did not respond, and 17 patients achieved partial remission. Among those 17 patients, 12 could be treated with a second course of rituximab, and 10 (83.3%) achieved CR, yielding an intention-to-treat CR rate of 60.5%. Eight patients excluded from the trial because of absence of CR were treated with rituximab combined with chemotherapy, and six (75%) achieved CR. Event-free survival was 42% and overall survival was 47% at 27.5 months. Fourteen patients died, ten of progression of their post-transplant lymphoproliferative disorder. INTERPRETATION AND CONCLUSIONS These results confirm that extended treatment with rituximab can obtain a high rate of CR in patients with post-transplant lymphoproliferative disorders after solid organ transplantation without increasing toxicity, and should be recommended as initial therapy for these patients.

Clinical Trial, Phase II; Journal Article; Multicenter Study;

Identificador

González-Barca E, Domingo-Domenech E, Capote FJ, Gómez-Codina J, Salar A, Bailen A, et al. Prospective phase II trial of extended treatment with rituximab in patients with B-cell post-transplant lymphoproliferative disease. Haematologica. 2007; 92(11):1489-94

1592-8721 (Online)

0390-6078 (Print)

http://hdl.handle.net/10668/1293

18024397

10.3324/haematol.11360

Idioma(s)

en

Publicador

Ferrata Storti Foundation

Relação

Haematologica

http://www.haematologica.org/content/92/11/1489.abstract

Direitos

Acceso abierto

Palavras-Chave #Post-transplant lymphoproliferative disorders #Rituximab #Prognostic factors #Anticuerpos monoclonales #Estudios prospectivos #Trastornos linfoproliferativos #Trasplante de órganos #Resultado del tratamiento #Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged #Medical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Antibodies, Monoclonal #Medical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Antibodies, Monoclonal::Antibodies, Monoclonal, Murine-Derived #Medical Subject Headings::Anatomy::Hemic and Immune Systems::Blood::Blood Cells::Leukocytes::Leukocytes, Mononuclear::Lymphocytes::B-Lymphocytes #Medical Subject Headings::Check Tags::Female #Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans #Medical Subject Headings::Diseases::Hemic and Lymphatic Diseases::Lymphatic Diseases::Lymphoproliferative Disorders #Medical Subject Headings::Check Tags::Male #Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Transplantation::Organ Transplantation #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome #Medical Subject Headings::Named Groups::Persons::Age Groups::Adult
Tipo

info:eu-repo/semantics/article

info:eu-repo/semantics/published

Artículo