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

Usefulness and Limitations of Rituximab in Managing Patients With Lymphoproliferative Disorder After Heart Transplantation

“…18 Other reports suggest a response rate of 37% to 69% over an 8-to 32-month follow-up. 12,[19][20][21][22][23][24][25][26] The factors explaining the differences in rate response are still unknown; clear predictors of complete remission after rituximab also are not identified. In the largest prospective trial of rituximab in PTLD, Choquet and associates showed that in patients unresponsive to reduction of immunosuppression, adjunct rituximab resulted in a response rate of 44% (including 28% remission) at 3 months.…”

Post Transplant Lymphoproliferative Disorders After Liver Transplantation

“…The majority of the case reports describe the use of rituximab in the early onset PTLD, but it might be effective also for patients with late onset PTLD. Gonzalez-Barca et al (Gonzalez-Barca E et al, 2004) reviewed data on 108 adult solid organ transplanted patients with PTLD including 36 patients who received rituximab. With a mean follow-up of 15 months, the OS of patients treated with rituximab was significantly better than for the whole group (76% vs. 21).…”

Posttransplant Lymphoproliferative Disorders Following Kidney Transplantation

“…With this approach the number of complete responders was upgraded from 34% after 4 admissions to 60.5% following 8 doses. 127 Although treatment with rituximab is associated with a high response rate in PTLD, it is important to keep in mind that it does not improve (virus-specific) cellular immunity necessitating the need for simultaneous RIS. 129 Conversely, severe B-cell depletion due to treatment with rituximab was not associated with diminished EBV-specific T-cell immunity in non-transplanted patients presenting with lymphoproliferative disorders.…”

“…122 Besides five prospective trials have been published till now assessing the role of rituximab in PTLD, showing overall response rates ranging between 44% and 64%. [124][125][126][127][128] Most patients were treated with the standard rituximab dose of 375 mg/m²/week during 4 consecutive weeks, although Gonzalez-Barca et al introduced the concept of risk adapted extended treatment with rituximab in case of partial response following 4 weekly admissions. With this approach the number of complete responders was upgraded from 34% after 4 admissions to 60.5% following 8 doses.…”