Allogeneic hematopoietic stem cell transplantation after rituximab-containing myeloablative preparative regimen for acute lymphoblastic leukemia

被引:32
作者
Kebriaei, P. [1 ]
Saliba, R. M. [1 ]
Ma, C. [1 ]
Ippoliti, C. [1 ]
Couriel, D. R. [1 ]
de Lima, M. [1 ]
Giralt, S. [1 ]
Qazilbash, M. H. [1 ]
Gajewski, J. L. [1 ]
Ha, C. S. [1 ]
Champlin, R. E. [1 ]
Khouri, I. F. [1 ]
机构
[1] Univ Texas, MD Anderson Canc Ctr, Dept Blood & Marrow Transplantat, Unit 423, Houston, TX 77030 USA
关键词
stem cell transplant; acute lymphoblastic leukemia; graft-versus-host disease;
D O I
10.1038/sj.bmt.1705425
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
We explored the safety and efficacy of rituximab administered in combination with the standard transplant conditioning regimen of cyclophosphamide (Cy) 120 mg/kg and total body irradiation (TBI) 12 Gy for adult patients with acute lymphoblastic leukemia (ALL). Patients were eligible if their disease expressed CD20. Rituximab was administered at 375 mg/m(2) weekly for four doses beginning on day -7 of the conditioning regimen. Graft-versus-host-disease (GVHD) prophylaxis consisted of tacrolimus and methotrexate. Thirty-five patients undergoing matched sibling (n=23) or unrelated donor (n=12) transplantation were studied, with a median age of 30 years (range 15-55 years). At 2 years, progression-free survival, treatment-related mortality, and overall survival were 30, 24, and 47%, respectively. There was no delay in engraftment or increased incidence of infection. The cumulative incidence of grade II-IV acute GVHD was 17%, and limited and extensive chronic GVHD was 43% at 2 years. The addition of rituximab to the standard Cy/TBI transplant conditioning regimen in ALL was safe and well tolerated, and there was a suggestion of decreased incidence of acute GVHD when compared to historically reported GVHD rates for this group of patients.
引用
收藏
页码:203 / 209
页数:7
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