Clinical applications of rituximab in allogeneic stem cell transplantation: Anti-tumor and immunomodulatory effects

Summary 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 the treatment of follicular lymphoma or in conjunction with other combination therapy as frontline or salvage therapy. Its efficiency in B-c...

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Veröffentlicht in:Cancer treatment reviews 2009-12, Vol.35 (8), p.653-661
Hauptverfasser: Ratanatharathorn, Voravit, Pavletic, Steven, Uberti, Joseph P
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creator Ratanatharathorn, Voravit
Pavletic, Steven
Uberti, Joseph P
description Summary 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 the 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 allogeneic stem cell transplantation. 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 patients 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. Therefore, 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 patients who had prior rituximab also suggest the early role of B-cells in allogeneic transplantation, thus opening the opportunity for further immune modulation to prevent acute GVHD.
doi_str_mv 10.1016/j.ctrv.2009.07.004
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identifier ISSN: 0305-7372
ispartof Cancer treatment reviews, 2009-12, Vol.35 (8), p.653-661
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subjects Acute Disease
Antibodies, Monoclonal - immunology
Antibodies, Monoclonal - therapeutic use
Antibodies, Monoclonal, Murine-Derived
Antineoplastic Agents - immunology
Antineoplastic Agents - therapeutic use
Antineoplastic Combined Chemotherapy Protocols - immunology
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
B-cells APC
B-cells in transplantation
B-Lymphocytes - drug effects
B-Lymphocytes - immunology
BMT
Chemokines - immunology
Chronic Disease
Cytokines - immunology
Graft vs Host Disease - complications
Graft vs Host Disease - immunology
Graft vs Host Disease - prevention & control
GVHD
Hematology, Oncology and Palliative Medicine
Hematopoietic Stem Cell Transplantation
Humans
Lymphoma, B-Cell - drug therapy
Lymphoma, B-Cell - immunology
Rituximab
Rituximab manuscript
T-Lymphocytes - immunology
Thrombocytopenia - immunology
Transplantation Conditioning
Transplantation, Homologous
title Clinical applications of rituximab in allogeneic stem cell transplantation: Anti-tumor and immunomodulatory effects
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