Ji Shi-Meng, Bao Xie-Bing, Lu Jun, Ma Xiao, Tao Tao, Sun Ai-Ning, Wu De-Pei, Xue Sheng-Li
Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Institute of Blood and Marrow Transplantation, Soochow University, Suzhou, China.
Indian J Hematol Blood Transfus. 2017 Dec;33(4):525-533. doi: 10.1007/s12288-017-0783-2. Epub 2017 Feb 8.
B cells are involved in chronic graft-versus-host disease (cGVHD) pathogenesis, and Rituximab may have a therapeutic effect on cGVHD in allogeneic hematopoietic stem cell transplantation (allo-HSCT) patients. Herein, we retrospectively evaluated the prophylactic effect of Rituximab on cGVHD in a group of Chinese allo-HSCT patients. A total of 102 patients, who suffered Epstein Barr virus (EBV) viremia within 100 days after allo-HSCT, were included in this study. Fifty patients received Rituximab (375 mg/m weekly) for EBV viremia, while fifty-two patients did not receive Rituximab. A competing risk model was adopted to compare cumulative incidence of cGVHD, cumulative incidence of relapse (CIR) and transplantation-related mortality (TRM) between two groups. Cumulative incidence of cGVHD in the Rituximab group was lower than in controls ( = 0.0579). Multivariate analyses confirmed that Rituximab was an independent factor for the reduction of cumulative cGVHD incidence ( = 0.0069). No significant difference was observed in CIR ( = 0.39) or TRM ( = 0.48) between two groups and 2-year OS and DFS were comparable (OS, = 0.667; DFS, = 0.571). Administration of Rituximab in the early post-transplantation phase may protect against cGVHD in allo-HSCT patients without increasing CIR or TRM.
B细胞参与慢性移植物抗宿主病（cGVHD）的发病机制，利妥昔单抗可能对异基因造血干细胞移植（allo-HSCT）患者的cGVHD有治疗作用。在此，我们回顾性评估了利妥昔单抗对一组中国allo-HSCT患者cGVHD的预防作用。本研究纳入了102例在allo-HSCT后100天内发生爱泼斯坦-巴尔病毒（EBV）血症的患者。50例患者因EBV血症接受利妥昔单抗治疗（375mg/m²每周一次），而52例患者未接受利妥昔单抗治疗。采用竞争风险模型比较两组之间cGVHD的累积发生率、复发累积发生率（CIR）和移植相关死亡率（TRM）。利妥昔单抗组的cGVHD累积发生率低于对照组（P = 0.0579）。多变量分析证实，利妥昔单抗是降低cGVHD累积发生率的独立因素（P = 0.0069）。两组之间在CIR（P = 0.39）或TRM（P = 0.48）方面未观察到显著差异，2年总生存率（OS）和无病生存率（DFS）相当（OS，P = 0.667；DFS，P = 0.571）。移植后早期给予利妥昔单抗可能预防allo-HSCT患者发生cGVHD，而不增加CIR或TRM。
