TY - JOUR
T1 - Effect of Rituximab on Pulmonary Function in Bronchiolitis Obliterans Syndrome due to Graft-Versus-Host-Disease
AU - Brownback, Kyle R.
AU - Thomas, Laura A.
AU - McGuirk, Joseph P.
AU - Ganguly, Siddhartha
AU - Streiler, Christopher
AU - Abhyankar, Sunil
N1 - Funding Information:
The authors would like to acknowledge the physicians involved with the bone marrow transplant team at the University of Kansas Medical Center, including Dr. Anurag Singh, Dr. Tara Lin, Dr. Leyla Shune and Dr. Omar Aljitawi. No funding was received in the production of this manuscript. The authors have no conflict of interest to disclose.
Publisher Copyright:
© 2017, Springer Science+Business Media, LLC.
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Purpose: Rituximab is an anti-CD20 monoclonal antibody that is used to suppress B-cell function in graft-versus-host-disease (GVHD). We sought to determine the effects of rituximab treatment on lung function in those patients with bronchiolitis obliterans syndrome (BOS) as a manifestation of GVHD. Methods: Thirteen patients were treated with rituximab with a diagnosis of BOS and a significant reduction in the forced expiratory volume in 1 s (FEV1) after hematopoietic stem cell transplantation (HSCT). The changes in their pulmonary function for 12 months following treatment with rituximab were followed, along with other intervention performed and daily average dosing of prednisone. Results: Following rituximab administration, there was an improvement in the slope of decline in lung function from −5.12 ml/month prior to rituximab infusion to −0.31 ml/month after 3 months and to +2.27 ml/month 12 months later. Seven of the 13 patients had an increase in their FEV1 after treatment with rituximab. Additionally, the mean daily dose of prednisone decreased from 27 mg prior to rituximab treatment to 11 mg 12 months after treatment. Nine out of 13 patients survived 12 months after rituximab treatment. All of the patients with improvement in FEV1 following rituximab treatment were receiving concomitant extracorporeal photopheresis. Conclusion: Rituximab is safe with the potential to stabilize or improve lung function in patients with BOS after HSCT and should be considered as a treatment option in those patients.
AB - Purpose: Rituximab is an anti-CD20 monoclonal antibody that is used to suppress B-cell function in graft-versus-host-disease (GVHD). We sought to determine the effects of rituximab treatment on lung function in those patients with bronchiolitis obliterans syndrome (BOS) as a manifestation of GVHD. Methods: Thirteen patients were treated with rituximab with a diagnosis of BOS and a significant reduction in the forced expiratory volume in 1 s (FEV1) after hematopoietic stem cell transplantation (HSCT). The changes in their pulmonary function for 12 months following treatment with rituximab were followed, along with other intervention performed and daily average dosing of prednisone. Results: Following rituximab administration, there was an improvement in the slope of decline in lung function from −5.12 ml/month prior to rituximab infusion to −0.31 ml/month after 3 months and to +2.27 ml/month 12 months later. Seven of the 13 patients had an increase in their FEV1 after treatment with rituximab. Additionally, the mean daily dose of prednisone decreased from 27 mg prior to rituximab treatment to 11 mg 12 months after treatment. Nine out of 13 patients survived 12 months after rituximab treatment. All of the patients with improvement in FEV1 following rituximab treatment were receiving concomitant extracorporeal photopheresis. Conclusion: Rituximab is safe with the potential to stabilize or improve lung function in patients with BOS after HSCT and should be considered as a treatment option in those patients.
KW - Bronchiolitis obliterans syndrome
KW - Extracorporeal photopheresis
KW - Graft-versus-host-disease
KW - Rituximab
KW - Ruxolitinib
KW - Stem cell transplantation
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U2 - 10.1007/s00408-017-0051-0
DO - 10.1007/s00408-017-0051-0
M3 - Article
C2 - 28894914
AN - SCOPUS:85029076967
SN - 0341-2040
VL - 195
SP - 781
EP - 788
JO - Lung
JF - Lung
IS - 6
ER -