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Article: Treatment of Epstein Barr virus-induced haemophagocytic lymphohistiocytosis with rituximab-containing chemo-immunotherapeutic regimens

TitleTreatment of Epstein Barr virus-induced haemophagocytic lymphohistiocytosis with rituximab-containing chemo-immunotherapeutic regimens
Authors
KeywordsEpstein-Barr virus
Haemophagocytic lymphohistiocytosis
Macrophage activation syndrome
Rituximab
X-linked lymphoproliferative disease
Issue Date2013
PublisherWiley-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?
AbstractHaemophagocytic 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 Identifierhttp://hdl.handle.net/10722/255124
ISSN
2015 Impact Factor: 5.401
2015 SCImago Journal Rankings: 2.313

 

DC FieldValueLanguage
dc.contributor.authorChellapandian, D-
dc.contributor.authorDas, R-
dc.contributor.authorZelley, K-
dc.contributor.authorWiener, SJ-
dc.contributor.authorZhao, H-
dc.contributor.authorTeachey, DT-
dc.contributor.authorNichols, KE-
dc.contributor.authorHo, MHK in EBV‐HLH Rituximab Study Group-
dc.date.accessioned2018-06-26T08:09:45Z-
dc.date.available2018-06-26T08:09:45Z-
dc.date.issued2013-
dc.identifier.citationBritish Journal of Haematology, 2013, v. 162 n. 3, p. 376-382-
dc.identifier.issn0007-1048-
dc.identifier.urihttp://hdl.handle.net/10722/255124-
dc.description.abstractHaemophagocytic 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.languageeng-
dc.publisherWiley-Blackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/BJH-
dc.relation.ispartofBritish Journal of Haematology-
dc.rightsPreprint 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.subjectEpstein-Barr virus-
dc.subjectHaemophagocytic lymphohistiocytosis-
dc.subjectMacrophage activation syndrome-
dc.subjectRituximab-
dc.subjectX-linked lymphoproliferative disease-
dc.titleTreatment of Epstein Barr virus-induced haemophagocytic lymphohistiocytosis with rituximab-containing chemo-immunotherapeutic regimens-
dc.typeArticle-
dc.identifier.emailHo, MHK: marcoho@hku.hk-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1111/bjh.12386-
dc.identifier.pmid23692048-
dc.identifier.scopuseid_2-s2.0-84880319443-
dc.identifier.hkuros218818-
dc.identifier.volume162-
dc.identifier.issue3-
dc.identifier.spage376-
dc.identifier.epage382-
dc.publisher.placeUnited Kingdom-

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