Journal
BONE MARROW TRANSPLANTATION
Volume 55, Issue 7, Pages 1326-1336Publisher
SPRINGERNATURE
DOI: 10.1038/s41409-020-0928-z
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Funding
- National Key Research and Development Program of China [2017YFA0104500]
- Beijing Municipal Science and Technology Commission [Z181100009618032]
- National Natural Science Foundation of China [81470342]
- Key Program of National Natural Science Foundation of China [81230013]
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To define the efficacy of a single dose of 375 mg/m(2) rituximab for DSA-positive patients with 2000 <= MFI < 10,000, we enrolled a prospective clinical cohort including patients with positive DSA treated with rituximab (n = 55, cohort A), a matched-pair cohort including cases with negative DSA (n = 110, cohort B) and a historical cohort including subjects with 2000 <= MFI < 10,000 without receiving any treatment for DSA (n = 22, cohort C). The incidences of primary poor graft function (PGF) in cohort A and cohort B were 5% and 1% (P = 0.076), respectively, both of which were lower than that in cohort C (27%, P < 0.001, for all). Rituximab was associated with a reduced incidence of primary PGF (HR 0.200, P = 0.023). The 3-year nonrelapse mortality of patients in cohort A and cohort B were 23% and 24%, respectively, both of which were lower than that in the cohort C (37%), although no statistical significance was observed. These results led to a low 3-year overall survival in patients in the cohort C (58%) compared with those in the cohort A (71%) and the cohort B (73%). We suggest that a single dose of rituximab could be effectively used to prevent the onset of primary PGF. The prospective cohort of this study is registered at http://www.chictr.org.cn/ChiCTR-OPC-15006672..
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