Table of Content

Current Issue

Spring 2019, Vol. 27 No. 1

Hong Kong J. Dermatol. Venereol. (2019) 27, 12-18


Original Article

Rituximab as salvage therapy for refractory sclerodermatous chronic graft-versus-host disease

利妥昔單抗作為難治性硬皮病樣慢性移植物抗宿主病的搶救治療

S Namdaroglu, D Iskender, MS Dal, MK Cakar, E Tekgunduz, F Altuntas

Abstract

While various different treatments have been suggested for the treatment of sclerodermatous graft-versus-host disease (ScGVHD), there is still no accepted standard for "salvage therapy" for refractory ScGVHD. We reviewed the clinical outcome of 14 patients suffering from refractory ScGVHD with refractory to at least 3 lines of immunosuppressive therapy and who received intravenous infusions of rituximab (375 mg/m2 per infusion) at weekly intervals for 4 weeks. Response to rituximab was evaluated after three months following the final infusion in accordance with National Institute of Health criteria. Median follow-up after rituximab was 20 months (range, 0.4-38.4 months). The overall response rate at was 43%. No major toxic events were seen related to rituximab.Rituximab appears to work well in the treatment of refractory ScGVHD and further trials in patients with early stage of this disease ought to be considered.

儘管已有各種不同治療方法建議用來治療硬皮病樣移植物抗宿主病,但對於難治性的硬皮病樣移植物抗宿主病仍然沒有公認的「補救治療」標準。我們回顧了此病14例難治性個案(至少對三種免疫抑制治療無效)的臨床結果。患者每週靜脈輸注利妥昔單抗(每次輸注375毫克/平方米),持續四週;我們根據美國國立衛生研究院(NIH)標準,在最終輸注後三個月對利妥昔單抗的反應進行了評估。利妥昔單抗後的中位隨訪時間為20個月(範圍為0.4-38.4個月),整體有效率為43%。沒有發現與利妥昔單抗有關的重大藥物毒性事件。利妥昔單抗似乎在治療難治性硬皮病樣移植物抗宿主病方面效果良好,可繼而考慮在此病早期患者作進一步的試驗。

Keywords: Haematopoietic stem cell transplantation, rituximab, salvage therapy, sclerodermatous chronic graft-versus-host disease

關鍵詞: 造血幹細胞移植,利妥昔單抗,搶救治療,硬皮病樣慢性移植物抗宿主病