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- Publisher Website: 10.1111/bjh.12386
- Scopus: eid_2-s2.0-84880319443
- PMID: 23692048
- WOS: WOS:000321568800011
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Article: Treatment of Epstein Barr virus-induced haemophagocytic lymphohistiocytosis with rituximab-containing chemo-immunotherapeutic regimens
Title | Treatment of Epstein Barr virus-induced haemophagocytic lymphohistiocytosis with rituximab-containing chemo-immunotherapeutic regimens |
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Authors | |
Keywords | Epstein-Barr virus Haemophagocytic lymphohistiocytosis Macrophage activation syndrome Rituximab X-linked lymphoproliferative disease |
Issue Date | 2013 |
Publisher | Wiley-Blackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/BJH |
Citation | British Journal of Haematology, 2013, v. 162 n. 3, p. 376-382 How to Cite? |
Abstract | Haemophagocytic lymphohistiocytosis (HLH) is a life threatening complication of Epstein-Barr virus (EBV) infection. The anti-CD20 antibody rituximab depletes B cells, leading to improved outcomes for patients with EBV-associated B-lymphoproliferative disorders. To gather data on the use of rituximab in EBV-HLH, we performed a retrospective investigation involving 42 EBV-HLH patients who had received treatment with rituximab-containing regimens. On average, patients received 3 rituximab infusions (range 1-10) at a median dose of 375 mg/m2. In all patients, rituximab was administered with other HLH-directed medications, including steroids, etoposide and/or ciclosporin. Rituximab-containing regimens appeared well tolerated and improved clinical status in 43% of patients. Examination of laboratory data obtained prior to and within 2-4 weeks after the first rituximab dose revealed significant reductions in EBV load (median load pre-rituximab: 114 200 copies/ml, median post-rituximab: 225 copies/ml, P = 0·0001) and serum ferritin levels (median ferritin pre-rituximab: 4260 μg/l, median post-rituximab: 1149 μg/l, P = 0·001). Thus, when combined with conventional HLH-directed therapies, rituximab improves symptoms, reduces viral load and diminishes inflammation. These data support the incorporation of rituximab into future prospective clinical trials for patients with EBV-HLH. © 2013 John Wiley & Sons Ltd. |
Persistent Identifier | http://hdl.handle.net/10722/255124 |
ISSN | 2023 Impact Factor: 5.1 2023 SCImago Journal Rankings: 1.574 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Chellapandian, D | - |
dc.contributor.author | Das, R | - |
dc.contributor.author | Zelley, K | - |
dc.contributor.author | Wiener, SJ | - |
dc.contributor.author | Zhao, H | - |
dc.contributor.author | Teachey, DT | - |
dc.contributor.author | Nichols, KE | - |
dc.contributor.author | Ho, MHK in EBV‐HLH Rituximab Study Group | - |
dc.date.accessioned | 2018-06-26T08:09:45Z | - |
dc.date.available | 2018-06-26T08:09:45Z | - |
dc.date.issued | 2013 | - |
dc.identifier.citation | British Journal of Haematology, 2013, v. 162 n. 3, p. 376-382 | - |
dc.identifier.issn | 0007-1048 | - |
dc.identifier.uri | http://hdl.handle.net/10722/255124 | - |
dc.description.abstract | Haemophagocytic lymphohistiocytosis (HLH) is a life threatening complication of Epstein-Barr virus (EBV) infection. The anti-CD20 antibody rituximab depletes B cells, leading to improved outcomes for patients with EBV-associated B-lymphoproliferative disorders. To gather data on the use of rituximab in EBV-HLH, we performed a retrospective investigation involving 42 EBV-HLH patients who had received treatment with rituximab-containing regimens. On average, patients received 3 rituximab infusions (range 1-10) at a median dose of 375 mg/m2. In all patients, rituximab was administered with other HLH-directed medications, including steroids, etoposide and/or ciclosporin. Rituximab-containing regimens appeared well tolerated and improved clinical status in 43% of patients. Examination of laboratory data obtained prior to and within 2-4 weeks after the first rituximab dose revealed significant reductions in EBV load (median load pre-rituximab: 114 200 copies/ml, median post-rituximab: 225 copies/ml, P = 0·0001) and serum ferritin levels (median ferritin pre-rituximab: 4260 μg/l, median post-rituximab: 1149 μg/l, P = 0·001). Thus, when combined with conventional HLH-directed therapies, rituximab improves symptoms, reduces viral load and diminishes inflammation. These data support the incorporation of rituximab into future prospective clinical trials for patients with EBV-HLH. © 2013 John Wiley & Sons Ltd. | - |
dc.language | eng | - |
dc.publisher | Wiley-Blackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/BJH | - |
dc.relation.ispartof | British Journal of Haematology | - |
dc.rights | Preprint This is the pre-peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article]. Authors are not required to remove preprints posted prior to acceptance of the submitted version. Postprint This is the accepted version of the following article: [full citation], which has been published in final form at [Link to final article]. | - |
dc.subject | Epstein-Barr virus | - |
dc.subject | Haemophagocytic lymphohistiocytosis | - |
dc.subject | Macrophage activation syndrome | - |
dc.subject | Rituximab | - |
dc.subject | X-linked lymphoproliferative disease | - |
dc.title | Treatment of Epstein Barr virus-induced haemophagocytic lymphohistiocytosis with rituximab-containing chemo-immunotherapeutic regimens | - |
dc.type | Article | - |
dc.identifier.email | Ho, MHK: marcoho@hku.hk | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1111/bjh.12386 | - |
dc.identifier.pmid | 23692048 | - |
dc.identifier.scopus | eid_2-s2.0-84880319443 | - |
dc.identifier.hkuros | 218818 | - |
dc.identifier.volume | 162 | - |
dc.identifier.issue | 3 | - |
dc.identifier.spage | 376 | - |
dc.identifier.epage | 382 | - |
dc.identifier.isi | WOS:000321568800011 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 0007-1048 | - |