Rituxan: Prevention of Post-transplant Lymphoproliferative Disorders – pro

Anti-CD20 (Rituximab) is a humanised monoclonocal antibody directed against the specific CD20 antigens found on B lymphocytes plasma membrane. It has been approved by the FDA for the treatment of lymphoma and post-transplant lymphoproliferative diseases. The rationale for using Rituxan for treating EBV infections is that it can destroy B cells and thus “dampen” T-cell response caused by immune dysregulation. After bone marrow transplantation (BMT) using T-cell-depleted marrow from an unrelated donor or HLA-mismatched related donor, the risk of developing lymphoproliferative disease associated with the Epstein-Barr virus (EBV) ranges from 1% to 25%. Although this medicine has been approved by the Food and Drug Administration to treat patients with other types of lymphomas, and has been used to treat a small number of patients with EBV lymphomas and other types of B-cell leukemias, it has not been approved to try and prevent EBV-lymphomas. Use of Rituximab to try to prevent EBV-lymphomas is therefore experimental. Results of a recent study are awaited: Rituximab (Rituxan) for the Prevention of EBV-LPD Epstein Barr Virus (EBV) Lymphoproliferative Disorder Post T Cell Depleted Unrelated and HLA Mis-Matched Related HSCT,NCT00648037 Ingrid Kuehnle, M. Helen Huls, Zhensheng Liu, Micah Semmelmann, Robert A. Krance, Malcolm K. Brenner, Cliona M. Rooney, and Helen E. Heslop CD20 monoclonal antibody (rituximab) for therapy of Epstein-Barr virus lymphoma after hemopoietic stem-cell transplantation Blood 95: 1502-1505.

Gruhn B; Meerbach A; Häfer R; Zell R; Wutzler P; Zintl F
Pre-emptive therapy with rituximab for prevention of Epstein-Barr virus-associated lymphoproliferative disease after hematopoietic stem cell transplantation. Bone marrow transplantation 2003;31(11):1023-5.

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