Low‐Dose Chemotherapy and Rituximab for Posttransplant Lymphoproliferative Disease (PTLD): A Children's Oncology Group Report

Optimal therapy for posttransplant lymphoproliferative disease (PTLD) remains problematic. A phase II trial adding rituximab to a low‐dose cyclophosphamide and prednisone regimen was conducted for pediatric patients with Epstein–Barr virus (EBV) (+), CD20 (+) PTLD. Fifty‐five patients were enrolled. Toxicity was similar for cycles of therapy containing rituximab versus those without. The complete remission (CR) rate was 69% (95% confidence interval (CI); 57%–84%). Of 12 patients with radiographic evidence of persistent disease at the end of therapy, eight were in CR 28 weeks later without further PTLD therapy. There were 10 deaths, 3 due to infections while receiving therapy and 7 from PTLD. The 2‐year event‐free survival (alive with functioning original allograft and no PTLD) was 71% (95% CI: 57%–82%) and overall survival was 83% (95% CI: 69%–91%) with median follow‐up of 4.8 years. Due to small numbers, we were unable to determine significance of tumor histology, stage of disease, allograft type or early response to treatment on outcome. These data suggest rituximab combined with low‐dose chemotherapy is safe and effective in treating pediatric with EBV (+) PTLD following solid‐organ transplantation.

• Publication year

  2012

• Venue

  American Journal of Transplantation

• Publication date

  2012-11-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.1111/j.1600-6143.2012.04206.xPMID 22883417PMCID PMC3484187
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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