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Selective B-cell depletion with rituximab for the treatment of patients with acquired hemophilia.
- Source :
-
Blood [Blood] 2004 Jun 15; Vol. 103 (12), pp. 4424-8. Date of Electronic Publication: 2004 Mar 02. - Publication Year :
- 2004
-
Abstract
- The activity and safety profile of selective B-cell depletion with rituximab, an anti-CD20 monoclonal antibody, were evaluated in 10 patients with acquired hemophilia. Rituximab was given intravenously at the dose of 375 mg/m(2) once weekly for 4 consecutive weeks. Infusion-related side effects were observed in 3 patients but were of mild intensity and did not require discontinuation of treatment. Eight patients with Factor VIII (FVIII) inhibitor titers between 4 and 96 Bethesda units per milliliter (BU/mL) achieved a complete remission, which was defined as a return to normal FVIII activity and undetectable FVIII inhibitor titers. Two more patients with inhibitor levels greater than 100 BU/mL experienced only a partial transient decrease of the inhibitor after rituximab alone, but they achieved a complete response after being challenged with a combination of rituximab plus pulse intravenous cyclophosphamide. With a median follow-up of 28.5 months (range, 12-41 months), 3 patients have thus far relapsed. Retreatment with the monoclonal antibody at the same dose and schedule resulted in a new sustained response in all these patients. In conclusion, rituximab appears an effective and well-tolerated treatment for patients with acquired hemophilia and low inhibitor titers. A reinforcement of therapy with other agents seems to be required to achieve a full and durable response in those patients with high inhibitor levels.
- Subjects :
- Adult
Aged
Antibodies, Monoclonal adverse effects
Antibodies, Monoclonal, Murine-Derived
Antineoplastic Agents adverse effects
Antineoplastic Agents therapeutic use
Disease Progression
Factor VIII antagonists & inhibitors
Female
Humans
Lymphocyte Depletion
Male
Middle Aged
Monitoring, Immunologic
Rituximab
Time Factors
Antibodies, Monoclonal therapeutic use
von Willebrand Diseases drug therapy
von Willebrand Diseases immunology
Subjects
Details
- Language :
- English
- ISSN :
- 0006-4971
- Volume :
- 103
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Blood
- Publication Type :
- Academic Journal
- Accession number :
- 14996701
- Full Text :
- https://doi.org/10.1182/blood-2003-11-4075