Oncology Medical News about rituximab, allogeneic stem cell transplantation

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Clinical applications of rituximab in allogeneic stem cell transplantation: Anti-tumor and immunomodulatory effects
Cancer Treatment Reviews, 08/21/09

Ratanatharathorn V et al. - In a review of the clinical applications of rituximab in allogeneic stem cell transplantation (ASCT), it was concluded that effort to maintain expansion of Tregs might be important for long-term control of these diseases. Other B-cell targeting strategy directing against B-cell-activating factor (BAFF) or its receptor could be considered in conjunction with rituximab. Recent CIBMTR data on reduced cumulative incidence of acute GVHD in pts who had prior rituximab suggest the early role of B-cells in ASCT, thus opening the opportunity for further immune modulation to prevent acute GVHD.

Methods

Rituximab is a chimeric monoclonal antibody directed against CD20, a B-cell antigen expressed on B-cell lymphoma.
It is widely used as single agent for treatment of follicular lymphoma or in conjunction with other combination therapy as frontline or salvage therapy.
Its efficiency in B-cell depletion has lead to other applications such as therapy for autoimmune diseases, GVHD, and other immunologic complications in ASCT.

Results

Clinical responses to rituximab unveiled the role of B-cells in the pathogenesis of these disorders.
Attenuation of pathogenic antibody production partly explained the clinical response in pts with autoimmune disease and chronic GVHD, but other immune mechanisms might be operative as well.
Expansion of regulatory T-cells (Tregs) following rituximab therapy indicated the interaction of T- and B-cells in chronic GVHD.
Efforts to maintain expansion of Tregs might be important for long-term control of these diseases.

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