PROTECTIVE EFFECT ON CHRONIC GRAFT-VERSUS-HOST DISEASE OCCURRENCE IN ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION PATIENTS WITH EPSTEIN BARR VIRUS VIREMIA TREATED BY RITUXIMAB
(Abstract release date: 05/19/16)
EHA Library. Xue S. 06/09/16; 133059; E1510
Prof. Dr. Shengli Xue
Contributions
Contributions
Abstract
Abstract: E1510
Type: Eposter Presentation
Background
Chronic graft-versus-host disease (cGVHD) is an important cause of late morbidity, mortality and impaired quality of life in patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT). It has been demonstrated that B cells are involved in cGVHD pathogenesis, which is evidenced by the presence of antibodies reactive to the host tissue in allo-HSCT patients with active cGVHD. It has also been proven that Rituximab could have a distinctly therapeutic effect on cGVHD in allo-HSCT patients. And now the prophylactic effect of Rituximab on cGVHD is being focused on. However, until now, no related studies have been conducted in Chinese patients.
Aims
To assess the prophylactic effect of Rituximab on cGVHD, a group of Chinese allo-HSCT patients receiving Rituximab to eliminate EBV viremia within 100 days following transplant is retrospectively evaluated.
Methods
Between January 2012 and August 2014, a total of 102 allo-HSCT patients from the First Affiliated Hospital of Soochow University, who underwent a myeloablative conditioning regimen and suffered EBV viremia within post-transplantation 100 days with a median time of 54 days (range 14-99), were included in this study. Among them, 50 (49%) patients (Rituximab group) received Rituximab treatment by 375mg/m2 weekly to deal with EBV viremia, while other 52 cases (control group) were treated by other anti-EBV agents. A competing risk model was adopted to compare the cumulative incidence of cGVHD, relapse rate and transplantation related mortality (TRM) between Rituximab group and control group. Death and relapse were treated as competing events in the analysis of cGVHD. Overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan-Meier method.
Results
All patients either in Rituximab group or in control group achieved viral load negativity except 3 patients who died before achieving viral negativity. In the Rituximab group, the median start time of Rituximab administration is post-transplantation 64 days (range 23–101) and the median count number of Rituximab administrations was 1 (range 1-4). The overall cumulative incidence of cGVHD in the cohort at 6-, 12-, 24-month were 23.5%, 42.2% and 46.1%, respectively. Retrospectively, the cumulative incidence of cGVHD in Rituximab group was lower at each time point (14.0% vs. 32.7%, 34.0% vs. 50%, 36.1% vs. 54.1% at 6-, 12-, 24-month, respectively, P = 0.059) when compared with controls. Moreover, there was no significant difference regarding cumulative relapse rate (P = 0.48) and TRM (P = 0.39) between two groups. Multivariable analyses corrected by other factors showed that Rituximab was one of the independent factors for the reduction of cumulative incidence of cGVHD (Hazard ratio (HR) = 0.37, 95%CI = 0.178 – 0.767, P = 0.0075). Additionally, survival analyses showed that there was no significant difference between two groups regarding overall survival (OS) (P = 0.667) or progression free survival (PFS) (P = 0.571).
Conclusion
Rituximab administrated in post-transplantation early phase could reduce the cumulative incidence of cGVHD and play a protective role in cGVHD occurrence among allo-HSCT patients but without increasing relapse rate and TRM.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Chronic graft-versus-host, Epstein barr virus, Rituximab
Type: Eposter Presentation
Background
Chronic graft-versus-host disease (cGVHD) is an important cause of late morbidity, mortality and impaired quality of life in patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT). It has been demonstrated that B cells are involved in cGVHD pathogenesis, which is evidenced by the presence of antibodies reactive to the host tissue in allo-HSCT patients with active cGVHD. It has also been proven that Rituximab could have a distinctly therapeutic effect on cGVHD in allo-HSCT patients. And now the prophylactic effect of Rituximab on cGVHD is being focused on. However, until now, no related studies have been conducted in Chinese patients.
Aims
To assess the prophylactic effect of Rituximab on cGVHD, a group of Chinese allo-HSCT patients receiving Rituximab to eliminate EBV viremia within 100 days following transplant is retrospectively evaluated.
Methods
Between January 2012 and August 2014, a total of 102 allo-HSCT patients from the First Affiliated Hospital of Soochow University, who underwent a myeloablative conditioning regimen and suffered EBV viremia within post-transplantation 100 days with a median time of 54 days (range 14-99), were included in this study. Among them, 50 (49%) patients (Rituximab group) received Rituximab treatment by 375mg/m2 weekly to deal with EBV viremia, while other 52 cases (control group) were treated by other anti-EBV agents. A competing risk model was adopted to compare the cumulative incidence of cGVHD, relapse rate and transplantation related mortality (TRM) between Rituximab group and control group. Death and relapse were treated as competing events in the analysis of cGVHD. Overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan-Meier method.
Results
All patients either in Rituximab group or in control group achieved viral load negativity except 3 patients who died before achieving viral negativity. In the Rituximab group, the median start time of Rituximab administration is post-transplantation 64 days (range 23–101) and the median count number of Rituximab administrations was 1 (range 1-4). The overall cumulative incidence of cGVHD in the cohort at 6-, 12-, 24-month were 23.5%, 42.2% and 46.1%, respectively. Retrospectively, the cumulative incidence of cGVHD in Rituximab group was lower at each time point (14.0% vs. 32.7%, 34.0% vs. 50%, 36.1% vs. 54.1% at 6-, 12-, 24-month, respectively, P = 0.059) when compared with controls. Moreover, there was no significant difference regarding cumulative relapse rate (P = 0.48) and TRM (P = 0.39) between two groups. Multivariable analyses corrected by other factors showed that Rituximab was one of the independent factors for the reduction of cumulative incidence of cGVHD (Hazard ratio (HR) = 0.37, 95%CI = 0.178 – 0.767, P = 0.0075). Additionally, survival analyses showed that there was no significant difference between two groups regarding overall survival (OS) (P = 0.667) or progression free survival (PFS) (P = 0.571).
Conclusion
Rituximab administrated in post-transplantation early phase could reduce the cumulative incidence of cGVHD and play a protective role in cGVHD occurrence among allo-HSCT patients but without increasing relapse rate and TRM.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Chronic graft-versus-host, Epstein barr virus, Rituximab
Abstract: E1510
Type: Eposter Presentation
Background
Chronic graft-versus-host disease (cGVHD) is an important cause of late morbidity, mortality and impaired quality of life in patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT). It has been demonstrated that B cells are involved in cGVHD pathogenesis, which is evidenced by the presence of antibodies reactive to the host tissue in allo-HSCT patients with active cGVHD. It has also been proven that Rituximab could have a distinctly therapeutic effect on cGVHD in allo-HSCT patients. And now the prophylactic effect of Rituximab on cGVHD is being focused on. However, until now, no related studies have been conducted in Chinese patients.
Aims
To assess the prophylactic effect of Rituximab on cGVHD, a group of Chinese allo-HSCT patients receiving Rituximab to eliminate EBV viremia within 100 days following transplant is retrospectively evaluated.
Methods
Between January 2012 and August 2014, a total of 102 allo-HSCT patients from the First Affiliated Hospital of Soochow University, who underwent a myeloablative conditioning regimen and suffered EBV viremia within post-transplantation 100 days with a median time of 54 days (range 14-99), were included in this study. Among them, 50 (49%) patients (Rituximab group) received Rituximab treatment by 375mg/m2 weekly to deal with EBV viremia, while other 52 cases (control group) were treated by other anti-EBV agents. A competing risk model was adopted to compare the cumulative incidence of cGVHD, relapse rate and transplantation related mortality (TRM) between Rituximab group and control group. Death and relapse were treated as competing events in the analysis of cGVHD. Overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan-Meier method.
Results
All patients either in Rituximab group or in control group achieved viral load negativity except 3 patients who died before achieving viral negativity. In the Rituximab group, the median start time of Rituximab administration is post-transplantation 64 days (range 23–101) and the median count number of Rituximab administrations was 1 (range 1-4). The overall cumulative incidence of cGVHD in the cohort at 6-, 12-, 24-month were 23.5%, 42.2% and 46.1%, respectively. Retrospectively, the cumulative incidence of cGVHD in Rituximab group was lower at each time point (14.0% vs. 32.7%, 34.0% vs. 50%, 36.1% vs. 54.1% at 6-, 12-, 24-month, respectively, P = 0.059) when compared with controls. Moreover, there was no significant difference regarding cumulative relapse rate (P = 0.48) and TRM (P = 0.39) between two groups. Multivariable analyses corrected by other factors showed that Rituximab was one of the independent factors for the reduction of cumulative incidence of cGVHD (Hazard ratio (HR) = 0.37, 95%CI = 0.178 – 0.767, P = 0.0075). Additionally, survival analyses showed that there was no significant difference between two groups regarding overall survival (OS) (P = 0.667) or progression free survival (PFS) (P = 0.571).
Conclusion
Rituximab administrated in post-transplantation early phase could reduce the cumulative incidence of cGVHD and play a protective role in cGVHD occurrence among allo-HSCT patients but without increasing relapse rate and TRM.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Chronic graft-versus-host, Epstein barr virus, Rituximab
Type: Eposter Presentation
Background
Chronic graft-versus-host disease (cGVHD) is an important cause of late morbidity, mortality and impaired quality of life in patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT). It has been demonstrated that B cells are involved in cGVHD pathogenesis, which is evidenced by the presence of antibodies reactive to the host tissue in allo-HSCT patients with active cGVHD. It has also been proven that Rituximab could have a distinctly therapeutic effect on cGVHD in allo-HSCT patients. And now the prophylactic effect of Rituximab on cGVHD is being focused on. However, until now, no related studies have been conducted in Chinese patients.
Aims
To assess the prophylactic effect of Rituximab on cGVHD, a group of Chinese allo-HSCT patients receiving Rituximab to eliminate EBV viremia within 100 days following transplant is retrospectively evaluated.
Methods
Between January 2012 and August 2014, a total of 102 allo-HSCT patients from the First Affiliated Hospital of Soochow University, who underwent a myeloablative conditioning regimen and suffered EBV viremia within post-transplantation 100 days with a median time of 54 days (range 14-99), were included in this study. Among them, 50 (49%) patients (Rituximab group) received Rituximab treatment by 375mg/m2 weekly to deal with EBV viremia, while other 52 cases (control group) were treated by other anti-EBV agents. A competing risk model was adopted to compare the cumulative incidence of cGVHD, relapse rate and transplantation related mortality (TRM) between Rituximab group and control group. Death and relapse were treated as competing events in the analysis of cGVHD. Overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan-Meier method.
Results
All patients either in Rituximab group or in control group achieved viral load negativity except 3 patients who died before achieving viral negativity. In the Rituximab group, the median start time of Rituximab administration is post-transplantation 64 days (range 23–101) and the median count number of Rituximab administrations was 1 (range 1-4). The overall cumulative incidence of cGVHD in the cohort at 6-, 12-, 24-month were 23.5%, 42.2% and 46.1%, respectively. Retrospectively, the cumulative incidence of cGVHD in Rituximab group was lower at each time point (14.0% vs. 32.7%, 34.0% vs. 50%, 36.1% vs. 54.1% at 6-, 12-, 24-month, respectively, P = 0.059) when compared with controls. Moreover, there was no significant difference regarding cumulative relapse rate (P = 0.48) and TRM (P = 0.39) between two groups. Multivariable analyses corrected by other factors showed that Rituximab was one of the independent factors for the reduction of cumulative incidence of cGVHD (Hazard ratio (HR) = 0.37, 95%CI = 0.178 – 0.767, P = 0.0075). Additionally, survival analyses showed that there was no significant difference between two groups regarding overall survival (OS) (P = 0.667) or progression free survival (PFS) (P = 0.571).
Conclusion
Rituximab administrated in post-transplantation early phase could reduce the cumulative incidence of cGVHD and play a protective role in cGVHD occurrence among allo-HSCT patients but without increasing relapse rate and TRM.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, Chronic graft-versus-host, Epstein barr virus, Rituximab
{{ help_message }}
{{filter}}