No abstract available.
Antibodies, Monoclonal, Murine-Derived ; B-Lymphocytes ; Lymphoma, B-Cell ; Rituximab

Sensitized patients have a reduced chance of receiving a crossmath-negative organ, because of the presence of antibodies against a variety of human leukocyte antigen (HLA). There have been much attention and understanding on renal transplantation in sensitized patients, which led to attempts to remove alloantibodies and successful transplantation. Therefore, a positive crossmatch test and the presence of donor-specific anti-HLA antibodies are no longer a contraindication to renal transplantation. These desensitization protocols include intravenous immunoglobulin (IVIG), plasmapheresis (PP), and rituximab. IVIG therapy is performed in two forms, high dose IVIG and low dose IVIG in combination with PP. Rituximab is usually utilized in combination with IVIG therapy. Here we summarized the characterisitics of these strategies.
Antibodies ; Antibodies, Monoclonal, Murine-Derived ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Isoantibodies ; Kidney Transplantation ; Leukocytes ; Plasmapheresis ; Rituximab ; Transplants

The clinical manifestations of antisynthetase syndrome are severe interstitial pneumonitis, mild polyarthritis, and myositis. This disease is accompanied by anti-Jo-1 antibodies and anti-Ro/SSA antibodies and occasionally by the concurrence of anti-Jo-1 and anti-Ro/SSA antibodies, which leads to a more severe form of interstitial lung disease. In this case, the patient was transferred to our hospital because of pulmonary fibrosis with myositis and diagnosed with antisynthetase syndrome and the concurrence of anti-Jo-1 with anti-Ro/SSA antibodies. He was refractory to glucocorticoids, and developed leucopenia and thrombocytopenia. He was treated with rituximab infusions, but the interstitial pneumonitis progressed very rapidly and he died.
Antibodies ; Antibodies, Monoclonal, Murine-Derived ; Arthritis ; Glucocorticoids ; Humans ; Lung Diseases, Interstitial ; Myositis ; Pulmonary Fibrosis ; Rituximab ; Thrombocytopenia

PURPOSE: We assessed the absorbed dose to the tumor (Dosetumor) by using pretreatment FDG-PET and whole-body (WB) planar images in repeated radioimmunotherapy (RIT) with 131I rituximab for NHL. MATERIALS AND METHODS: Patients with NHL (n=4) were administered a therapeutic dose of (131)I rituximab. Serial WB planar images after RIT were acquired and overlaid to the coronal maximum intensity projection (MIP) PET image before RIT. On registered MIP PET and WB planar images, 2D-ROIs were drawn on the region of tumor (n=7) and left medial thigh as background, and Dosetumor was calculated. The correlation between Dosetumor and the CT-based tumor volume change after RIT was analyzed. The differences of Dosetumor and the tumor volume change according to the number of RIT were also assessed. RESULTS: The values of absorbed dose were 397.7+/-646.2cGy (53.0~2853.0cGy). The values of CT-based tumor volume were 11.3+/-9.1 cc (2.9~34.2cc), and the % changes of tumor volume before and after RIT were -29.8+/-44.3% (-100.0%~+42.5%), respectively. Dosetumor and the tumor volume change did not show the linear relationship (p>0.05). Dosetumor and the tumor volume change did not correlate with the number of repeated administration (p>0.05). CONCLUSION: We could determine the position and contour of viable tumor by MIP PET image. And, registration of PET and gamma camera images was possible to estimate the quantitative values of absorbed dose to tumor.
Antibodies, Monoclonal, Murine-Derived ; Gamma Cameras ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin ; Radioimmunotherapy ; Thigh ; Tumor Burden ; Rituximab

One of the most important adverse effects of a tumor necrosis factor (TNF)-alpha inhibitor is the reactivation of tuberculosis. Most of them occur in the lung, but sometimes they can be found in other organs. Moreover, the proper management of active rheumatoid arthritis (RA) in patients with anti-TNF-alpha associated tuberculosis is still in debate. We present the case of a seropositive RA patient who showed good response with rituximab, an anti-CD20 monoclonal antibody, after developing splenic tuberuculosis, following treatment with TNF-alpha inhibitor. Confirming a diagnosis of splenic tuberculosis is difficult and can be delayed due to its nonspecific symptoms and rare occurrence. This case suggests that splenic tuberculosis should be doubted in RA patients treated with TNF-alpha inhibitor, and that rituximab may be considered as an alternative treatment option in RA patients with anti-TNF-alpha associated tuberculosis.
Antibodies, Monoclonal, Murine-Derived ; Arthritis, Rheumatoid ; Humans ; Lung ; Tuberculosis ; Tuberculosis, Splenic ; Tumor Necrosis Factor-alpha ; Rituximab

OBJECTIVE: To assess the efficacy and safety of rituximab (RTX) on disease activity and muscle strength in patients with inflammatory myopathies refractory to conventional therapy. METHODS: Four inflammatory myopathy patients who had been refractory to glucocorticoids, one or more immunosuppressive therapies and intravenous immunoglobulin were treated on an open-label basis. Each patient received two 500 mg doses of RTX 2 weeks apart in one cycle. In one patient who did not respond after the first cycle of RTX, the infusion schedule was modified by the physician. We measured muscle enzyme including CPK, LDH and assessed muscle strength individually to evaluate RTX response. Additionally anti-CD19 antibody was measured. RESULTS: Three patients responded to the first cycle of RTX treatment with improvements in muscle enzyme and muscle strength, and then maintained physical function over the duration of several infusion cycles. In one patient, muscle enzyme did not decrease after the first cycle of RTX, and a high dose glucocorticoid was given. After modifying the treatment schedule with monthly RTX infusion, his muscle enzyme level and muscle strength improved. Anti-CD19 antibody decreased after RTX generally, but responses were variable. Herpes zoster infection occurred in two patients. CONCLUSION: Rituximab may be a therapeutic choice in refractory inflammatory myopathy. However a further trial is needed to confirm the efficacy and prove the safety.
Antibodies, Monoclonal, Murine-Derived ; Appointments and Schedules ; Glucocorticoids ; Herpes Zoster ; Humans ; Immunoglobulins ; Muscle Strength ; Muscles ; Myositis* ; Rituximab

Much progress has been made in the elucidation of potential pathogenetic mechanisms of glomerulonephritis such as anti-PLA2R autoantibody in membranous nephropathy and under-galactosylated IgA1 in IgA nephropathy as well as in the fields of treatment. This knowledge is, hopefully in the future, being applied in the development of the creation of rational therapeutic approaches. Current treatment strategies for glomerular diseases recommended by many clinical studies include high-dose glucocorticoids, calcineurin inhibitors, cyclophosphamide, mycophenolate mofetil, and rituximab. Although these therapies have been effective in treating immune-mediated glomerular diseases, they all have potentially serious side effects.
Antibodies, Monoclonal, Murine-Derived ; Calcineurin ; Cyclophosphamide ; Glomerulonephritis ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranous ; Glucocorticoids ; Immunoglobulin A ; Mycophenolic Acid ; Rituximab

Many studies have recently reported reactivation in hepatitis B surface antigen (HBsAg)-negative subjects with the use of biologic agents such as rituximab. However, occult hepatitis B virus infection itself has little clinical impact. We experienced a case of acute exacerbation caused by occult hepatitis B infection without HBsAg seroconversion. No mutation was found on the major hydrophilic loop of the S protein. The patient recovered from acute exacerbation after antiviral therapy. In conclusion, acute exacerbation can be induced by occult hepatitis B virus infection itself without reactivation. In such a case, antiviral therapy should be considered.
Antibodies, Monoclonal, Murine-Derived ; Hepatitis ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans ; Rituximab

The Consortium for Improving Survival of Lymphoma (CISL) in Korean Society of Hematology Lymphoma Working Party had first meeting in February, 2006 with 10 institutions and 12 members. Now CISL comprised of 64 centers. CISL has concentrated research activity on lymphomas which are relatively frequent in Korea and has tried to give favors for the Korean lymphoma patients. CISL has conducted more than 30 retrospective studies to evaluate Korean peculiar lymphoma subtypes. More than 30 prospective trials have been being performed for diffuse large B-cell lymphoma, marginal zone lymphoma, extra-nodal NK/T-cell lymphoma, and so on. The first prospective trial for advanced marginal zone lymphoma has led to use Rituximab containing chemotherapy with the re-imbursement of health insurance in Korea. The multi-center trials of the CISL with new therapeutic modalities will improve further the survival of lymphoma patients not only quantitatively but also qualitatively.
Antibodies, Monoclonal, Murine-Derived ; Hematology ; Humans ; Insurance, Health ; Korea ; Lymphoma ; Lymphoma, B-Cell ; Rituximab

BACKGROUNDRituximab in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) significantly prolonged event-free survival in first-line chemotherapy for patients with diffuse large B-cell lymphoma (DLBCL). But relapse and refractory DLBCL occur frequently. Although rituximab is effective, its role in salvage therapy after autologous transplant remains unclear. Maintenance therapy with rituximab in responding patients after first line chemotherapy may be a useful novel approach capable of eradicating minimal residual disease and to bring survival benefit. This systematic review and meta-analysis evaluated the effects of rituximab maintenance treatment and salvage therapy of patients with DLBCL.

METHODSWe performed a systematic review and meta-analysis of randomized controlled trials and compared rituximab maintenance or salvage therapy at relapse with observation. We searched the Cochrane Library, PubMed, EMBASE, conference proceedings, databases of ongoing trials, and references of published trials. Two reviewers independently assessed the quality of the trials and extracted data. Hazard ratios for time-to-event data were estimated and pooled.

RESULTSSeven trials including 1470 DLBCL patients were included in this systematic review and meta-analysis. Patients treated with maintenance rituximab have better overall survival (OS) and event-free survival (EFS) than patients in the observation arm, but there was no statistical significance. Patients who received rituximab salvage therapy for relapse or refractory DLBCL have statistically significantly better OS [HR of death = 0.72, 95% CI (0.55-0.94), P = 0.02], progression-free survival (PFS) [HR = 0.61, 95% CI (0.52-0.72), P < 0.05], odds ratio (OR) [RR = 1.26, 95% CI (1.07-1.47), P = 0.004] than patients in the observation arm. The rate of infection-related adverse events was higher with rituximab treatment [RR = 1.37, 95% CI = (1.14 - 1.65) P =0.001].

CONCLUSIONSAfter first-line chemotherapy, the two rituximab-combined treatment strategies, including maintenance and salvage therapies can bring survival benefit. But due to the few studies, the low methodological quality assessment and the low outcome evidence quality, it's not confirmed that the two strategies are better than normal chemotherapy regimens. More high-quality randomized controlled trials are still needed to provide reliable evidence. The higher rate of infections after rituximab therapy should be taken into consideration when making treatment decisions.