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Successful treatment of refractory donor lymphocyte infusion‐induced immune‐mediated pancytopenia with rituximab
Author(s) -
Kato Itaru,
Umeda Katsutsugu,
Awaya Tomonari,
Yui Yoshihiro,
Niwa Akira,
Fujino Hisanori,
Matsubara Hiroshi,
Watanabe KenIchiro,
Heike Toshio,
Adachi Naoto,
Endo Fumio,
Mizukami Tomoyuki,
Nunoi Hiroyuki,
Nakahata Tatsutoshi,
Adachi Souichi
Publication year - 2010
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22280
Subject(s) - pancytopenia , medicine , rituximab , refractory (planetary science) , donor lymphocyte infusion , immune system , graft versus host disease , lymphocyte , immunology , bone marrow , gastroenterology , autoantibody , disease , lymphoma , antibody , physics , astrobiology
A 6‐year‐old male with chronic granulomatous disease, who was transplanted with bone marrow and exhibited increasing mixed chimerism, subsequently received two donor lymphocyte infusions (DLI). Two weeks after the second DLI, the patient developed acute graft‐versus‐host disease (GVHD) and progressive pancytopenia that was associated with autoantibody production. Conventional treatment did not improve the pancytopenia. However, administration of Rituximab (RTX) (375 mg/m 2 /week for four consecutive weeks) resulted in a rapid resolution of the pancytopenia. The patient achieved full donor chimerism without GVHD symptoms. RTX can be valuable for managing immune‐mediated cytopenias that arise after DLI and are refractory to conventional therapies. Pediatr Blood Cancer 2010;54:329–331. © 2009 Wiley‐Liss, Inc.