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Published in: Lung 6/2017

01-12-2017

Effect of Rituximab on Pulmonary Function in Bronchiolitis Obliterans Syndrome due to Graft-Versus-Host-Disease

Authors: Kyle R. Brownback, Laura A. Thomas, Joseph P. McGuirk, Siddhartha Ganguly, Christopher Streiler, Sunil Abhyankar

Published in: Lung | Issue 6/2017

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Abstract

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.
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Metadata
Title
Effect of Rituximab on Pulmonary Function in Bronchiolitis Obliterans Syndrome due to Graft-Versus-Host-Disease
Authors
Kyle R. Brownback
Laura A. Thomas
Joseph P. McGuirk
Siddhartha Ganguly
Christopher Streiler
Sunil Abhyankar
Publication date
01-12-2017
Publisher
Springer US
Published in
Lung / Issue 6/2017
Print ISSN: 0341-2040
Electronic ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-017-0051-0

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