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Results: 5

1.
Figure 3

Figure 3. From: Prophylactic rituximab after allogeneic transplantation decreases B-cell alloimmunity with low chronic GVHD incidence.

Only 20% of patients receiving rituximab prophylaxis developed cGVHD. The cumulative incidence of cGVHD at 4 years was 20% (95% CI, 6%-34%).

Sally Arai, et al. Blood. 2012 June 21;119(25):6145-6154.
2.
Figure 5

Figure 5. From: Prophylactic rituximab after allogeneic transplantation decreases B-cell alloimmunity with low chronic GVHD incidence.

Overall survival after rituximab prophylaxis exceeds 70%. For the CLL patients, the 4-year overall survival was 73% (95% CI, 57%-94%) and freedom from progression was 47% (95% CI, 30%-75%). For the MCL patients, the 4-year overall survival was 69% (95% CI, 48%-99%) and freedom from progression was 53% (95% CI, 31%-89%).

Sally Arai, et al. Blood. 2012 June 21;119(25):6145-6154.
3.
Figure 1

Figure 1. From: Prophylactic rituximab after allogeneic transplantation decreases B-cell alloimmunity with low chronic GVHD incidence.

Trial schema. RIC using 80 cGy TLI for 10 days and ATG 1.5 mg/kg on days 1-5, followed by peripheral blood progenitor cell infusion on day 0. Rituximab infusion (375 mg/m2) was infused on days 56, 63, 70, 77. Cyclosporine and mycophenolate mofetil were used as primary GVHD prophylaxis. Triangles indicate time points for peripheral blood immune analyses.

Sally Arai, et al. Blood. 2012 June 21;119(25):6145-6154.
4.
Figure 4

Figure 4. From: Prophylactic rituximab after allogeneic transplantation decreases B-cell alloimmunity with low chronic GVHD incidence.

Rituximab prophylaxis prevents H-Y allogeneic Ab development. Blood IgGs against 5 H-Y antigens were determined by ELISA in 25 F → M HCT patients who never received rituximab after TLI-ATG (left panel) and 10 study patients treated with rituximab on days 56, 63, 70, and 77. These heat maps show that no alloreactive H-Y Abs developed in study patients receiving rituximab 2 months after TLI-ATG alloHCT, whereas 1 or more H-Y Abs developed in 56% (14 of 25) of patients receiving TLI-ATG without posttransplantation rituximab. Considering all patients who survived 9 months, rituximab prophylaxis prevents H-Y Ab development (P = .01).

Sally Arai, et al. Blood. 2012 June 21;119(25):6145-6154.
5.
Figure 2

Figure 2. From: Prophylactic rituximab after allogeneic transplantation decreases B-cell alloimmunity with low chronic GVHD incidence.

B-cell reconstitution and rituximab quantification. (A) Blood CD19+CD5CD23 B-cell quantification. Blood samples collected from HLA identical donors (○), and study subjects (●) before TLI-ATG conditioning and 56 days after alloHCT were FACS analyzed to quantify CD19+ B cells. Recipient MCL and CLL cancer cells were excluded from this donor B-cell quantification by excluding CD5+ or CD23+ cells. Blood CD19+CD5CD23 B-cell quantification performed 90 and 180 days after alloHCT showed limited donor B-cell recovery after rituximab. For comparison, donor B-cell recovery 56 days after TLI-ATG alloHCT was determined in 19 patients who never received rituximab (▴) to control for passive transmission of rituximab infused before HCT. (B) Rituximab infused 6 months or less before HCT is detected by ELISA at transplantation. Blood collected immediately before conditioning was measured by ELISA for rituximab concentration (μg/mL; y-axis). Each pre-HCT rituximab level was related to the number of months since their last rituximab infusion (x-axis). (C) CLL decreases following rituximab infusion 56 days after alloHCT. Immunophenotyping detected persistent CD19+CD5+CD23+ CLL cells 56 days after HCT in most CLL patients. Ten of 16 (63%) patients had > 10 CD19+CD5+CD23+ cells/μL of peripheral blood. After rituximab infusion, only 4 of 20 had CLL detected by flow cytometry on day 90. Twelve MCL patients had negligible CD19+CD5+CD23 cells in the blood measured on both days 56 and 90.

Sally Arai, et al. Blood. 2012 June 21;119(25):6145-6154.

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