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Rituximad Can Treat Chronic Graft-Versus-Host Disease: Study

s thinking has been challenged by research, by Dana-Farber's Jerome Ritz, MD, and others, that indicates that immune system B cells, as well as T cells, play a critical role in GVHD. (T cells are so named because they mature in the thymus gland, while B cells are derived from bone marrow.) This hypothesis gained traction when laboratory studies and small clinical trials showed that rituximab, which specifically targets B cells, could be effective against GVHD.

The new study reinforces those findings with the largest group of chronic GVHD patients yet treated with rituximab. The patients in the study had chronic GVHD that was resistant to the standard therapy of corticosteroids, and were on stable doses of other immune system-suppressing medications. Twenty of the study's 21 participants completed at least one 4-week course of treatment. All had received stem cell transplants at least six months before enrolling in the study.

In addition to reducing the severity of GVHD in nearly three-fourths of the study participants, rituximab enabled 68 percent of the participants to reduce the amount of corticosteroids they were taking by more than 50 percent. Patients reported few side effects of the rituximab therapy.

"We've demonstrated that anti-B cell therapy with rituximab is safe and effective for patients with steroid-resistant chronic GVHD," Cutler says. "It's becoming clearer that treatments for chronic GVHD will need to take account of both T cell and B cell activity in transplant recipients. The success of this approach suggests that anti-B cell therapies cold be tested as part of a strategy for preventing GVHD and treating it in its earliest stages.”

Dana-Farber Cancer Institute (http://www.danafarber.org) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC
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