Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018133 (graft-versus-host disease)
 18,032 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

While modern intensive chemotherapy protocols cure the majority of patients with Burkitt's lymphoma, the prospects of cure with salvage chemotherapy for relapsed or refractory disease are minimal. There are limited data on the results of allografting for well characterised Burkitt's lymphoma and in particular little on the impact of GVHD on transplant outcome. We report a patient with t(8;22) Burkitt's lymphoma who underwent an HLA-identical sibling allograft in second complete remission. Relapse occurred at day 60 post-transplant, without pre-existing GVHD. GVHD subsequently developed after withdrawal of immunosuppression and administration of alpha-interferon. Concomitantly the lymphoma regressed, consistent with a graft versus Burkitt's effect, until progression at day 200. A delayed, partial and transient response subsequently occurred to rituximab, a chimeric monoclonal antibody against the CD20 antigen. These observations suggest that immunotherapeutic approaches should be considered for Burkitt's lymphoma unable to be cured by conventional chemotherapy.
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PMID:Graft versus Burkitt's lymphoma effect after allogeneic marrow transplantation. 1215 81

Autologous hematopoietic stem cell transplantation is widely accepted as effective therapy for patients with relapsed aggressive B-cell non-Hodgkin's lymphoma, and to a lesser extent, for indolent and mantle cell lymphoma, resulting in prolonged disease-free survival. Despite these advances, disease recurrence remains a problem and a major clinical challenge. Allogeneic transplantation has also been increasingly utilized in patients with relapsed aggressive and indolent lymphoma but is associated with high toxicity and graft-versus-host disease. Recently, nonmyeloablative preparatory regimens have shown encouraging results, attributed to graft-versus-lymphoma effects. Rituximab, a monoclonal antibody targeted against the CD20 antigen, is a potent therapeutic tool with documented efficacy in B-cell lymphomas. It is effective when used alone or in combination with chemotherapy, resulting in a significantly improved response rate compared with chemotherapy alone, in both aggressive and indolent lymphomas. Increasing evidence suggests that rituximab is also effective at in vivo purging prior to transplantation and may prevent relapse by eradication of residual disease when administered after transplantation. This review summarizes the available data on the use of rituximab and discusses the current evidence for its role in conjunction with auto- and allotransplantation.
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PMID:The role of the anti-CD20 antibody rituximab in hematopoietic stem cell transplantation for non-Hodgkin's lymphoma. 1600 42