Use of rituximab in conjunction with immunosuppressive chemotherapy as a novel therapy for Epstein Barr virus-associated hemophagocytic lymphohistiocytosis.

Abstract

Hemophagocytic lymphohistiocytosis is a rare, life-threatening complication of Epstein Barr virus (EBV) infection. Current treatments are directed at reducing virus-induced immune dysregulation. Addition of agents that eliminate EBV-infected B cells may improve therapeutic efficacy. On the basis of the observations that the anti-CD-20 monoclonal antibody rituximab reduces disease burden in individuals with EBV-associated lymphoproliferative disorders, we treated a patient with severe EBV-hemophagocytic lymphohistiocytosis using a combination of rituximab and chemotherapy. This patient demonstrated a rapid clinical response and an 18-fold reduction in EBV viral load within 24 hours of receiving rituximab. He remains free of disease 8 months after completing treatment.

• Authors: Naomi J Balamuth, Kim E Nichols, Michele Paessler, David T Teachey
• Journal: Journal of pediatric hematology/oncology (J Pediatr Hematol Oncol) Vol. 29 Issue 8 Pg. 569-73 (Aug 2007) ISSN: 1077-4114 [Print] United States
• PMID: 17762500 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• Antineoplastic Agents
• Rituximab

Topics

• Adolescent
• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Murine-Derived
• Antineoplastic Agents (therapeutic use)
• Combined Modality Therapy
• Disease-Free Survival
• Epstein-Barr Virus Infections (complications, drug therapy)
• Herpesvirus 4, Human
• Humans
• Immunosuppression Therapy
• Lymphohistiocytosis, Hemophagocytic (drug therapy, virology)
• Male
• Rituximab