Rituximab as salvage therapy for refractory sclerodermatous chronic graft-versus-host disease

While various different treatments have been suggested for the treatment of sclerodermatous graft-versus-host disease (ScGVHD), there is still no accepted standard for "salvage therapy" for refractory ScGVHD. We reviewed the clinical outcome of 14 patients suffering from refractory ScGVHD with refractory to at least 3 lines of immunosuppressive therapy and who received intravenous infusions of rituximab (375 mg/m(2) per infusion) at weekly intervals for 4 weeks. Response to rituximab was evaluated after three months following the final infusion in accordance with National Institute of Health criteria. Median follow-up after rituximab was 20 months (range, 0.4-38.4 months). The overall response rate at was 43%. No major toxic events were seen related to rituximab. Rituximab appears to work well in the treatment of refractory ScGVHD and further trials in patients with early stage of this disease ought to be considered.