National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.
Front Immunol. 2022 Aug 31;13:967026. doi: 10.3389/fimmu.2022.967026. eCollection 2022.
Rituximab is used to eliminate B cells as a chimeric monoclonal antibody directed against CD20, a B-cell antigen expressed on B cells. To explore the impact of rituximab administered before transplantation, we implemented a retrospective, monocentric study and utilized real-world data collected at our center between January 2018 and December 2020, and then followed until December 2021. Based on whether a dose of 375mg/m rituximab was used at least once within two weeks before transplantation, patients undergoing allo-HSCT were classified into two groups: rituximab (N=176) and non-rituximab (N=344) group. Amongst all the patients, the application of rituximab decreased EBV reactivation (P<0.01) and rituximab was an independent factor in the prevention of EBV reactivation by both univariate and multivariate analyses (HR 0.56, 95%CI 0.33-0.97, P=0.04). In AML patients, there were significant differences in the cumulative incidence of aGVHD between the two groups (P=0.04). Our data showed that rituximab was association with a decreased incidence of aGVHD in AML patients according to both univariate and multivariate analyses. There was no difference between the two groups in other sets of populations. Thus, our study indicated that rituximab administered before transplantation may help prevent EBV reactivation in all allo-HSCT patients, as well as prevent aGVHD in AML patients after allo-HSCT.
利妥昔单抗是一种嵌合单克隆抗体，用于消除 B 细胞，其靶向的是 CD20，这是一种在 B 细胞上表达的 B 细胞抗原。为了探讨移植前使用利妥昔单抗的影响，我们实施了一项回顾性、单中心研究，利用了我们中心在 2018 年 1 月至 2020 年 12 月期间收集的真实世界数据，并随访至 2021 年 12 月。根据患者是否在移植前两周内至少使用过一次 375mg/m 的利妥昔单抗，将接受异基因 HSCT 的患者分为两组：利妥昔单抗组（N=176）和非利妥昔单抗组（N=344）。在所有患者中，利妥昔单抗的应用降低了 EBV 再激活（P<0.01），并且利妥昔单抗是 EBV 再激活预防的独立因素，无论是单变量还是多变量分析（HR 0.56，95%CI 0.33-0.97，P=0.04）。在 AML 患者中，两组间急性移植物抗宿主病（aGVHD）的累积发生率存在显著差异（P=0.04）。我们的数据显示，根据单变量和多变量分析，利妥昔单抗与 AML 患者 aGVHD 发生率降低有关。两组在其他人群中没有差异。因此，我们的研究表明，移植前使用利妥昔单抗可能有助于预防所有异基因 HSCT 患者的 EBV 再激活，并预防 AML 患者异基因 HSCT 后的 aGVHD。
