The efficacy and safety of rituximab in treatment of Epstein-Barr virus disease post allogeneic hematopoietic stem-cell transplantation
10.3760/cma.j.issn.0578-1426.2012.12.010
- VernacularTitle:利妥昔单抗治疗异基因造血干细胞移植后EB病毒病的疗效和安全性
- Author:
Lanping XU
;
Daihong LIU
;
Kaiyan LIU
;
Chunli ZHANG
;
Fengrong WANG
;
Jingzhi WANG
;
Yu WANG
;
Huan CHEN
;
Yuanyuan ZHANG
;
Chenhua YAN
;
Wei HAN
;
Yuhong CHEN
;
Ting ZHAO
;
Xiaohui ZHANG
;
Xiaojun HUANG
- Publication Type:Journal Article
- Keywords:
Epstein-Barr virus infections;
Haematopoietic stem-cell transplantation,allogeneic;
Lymphoproliferative disorders;
Rituxmab
- From:
Chinese Journal of Internal Medicine
2012;(12):966-970
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy and safety of rituximab on Epstein-Barr virus (EBV) disease post allogeneic hematopoietic stem-cell transplantation.Methods A retrospective analysis was performed based on clinical data of 26 patients diagnosed as EBV disease and received rituximab from June 2006 to March 2012 in People's Hospital,Beijing University.Eleven patients were diagnosed as posttransplant lymphoproliferative disorders (PTLD) by histopathology and remaining 15 were diagnosed as probable EBV disease.Patients received a rituximab dose of 375 mg/m2 once a week.Efficacy was evaluated as revised response criteria for non-hodgkin lymphoma (NHL),and side effects during infusion were evaluated by Common Terminology Criteria for Adverse Events.Results Patients received 78 infusions with a median of 3 (1-6) infusions in each.There were no severe side effects during the infusion of rituximab.The 1st,2nd,3rd,4th,8th week cumulative complete remission (CR) were (11.5 ± 6.3)％,(42.2 ±10.2) ％,(64.4 ± 10.0) ％,(74.6 ± 9.4) ％,(87.3 ± 7.9) ％,respectively.The overall response rate was 84.5％,and the CR rate was 73.1％.The CR rate was higher among patients with single organ involved than those with multiple organs involved (10/10 vs 9/16,P =0.023).The CR rate was higher in patients with probable EBV disease than those with PTLD (13/15 vs 6/11,P =0.095),while there was no statistically significant difference.The incidence of one-year and two-year overall survival since onset of rituximab were (55.7 ± 10.2)％ and (39.6 ± 12.4)％,respectively.Survival rate was higher among the patients with single organ involved than those with multiple organ involved (8/10 vs 5/16,P =0.041).Survival rate was higher in patients with probable EBV disease than those with PTLD(11/15 vs 2/11,P =0.015).Conclusions Rituximab appears to be safe and effective for EBV disease.Due to a potential good response in probable EBV disease,we suggest rituxmab should be given based on probable EBV disease;meanwhile the pathological results should get early if possible.Prospective trial is needed to provide evidence so as to define optimal therapy of rituxmab.
