Rituxan for Chronic GVHD
Dear OncoLink "Ask The Experts,"
My brother has chronic GVHD and all other treatments have failed so far. His doctor now has decided to try Rituximab. What can you tell me about this?
Deana Potts, MSN, CRNP, Advanced Practice Oncology Nurse, responds:
B-cells and T-cells are part of the immune system. GVHD, or graft versus host disease, is caused by donor T-cells that see the recipient as foreign and thus attack the recipient. Rituximab is a medication that is actually directed against B-cells. It is believed that you need B cells in order to activate T cells. So by removing the B cells with Rituximab, the T cells become less functional and therefore may mount less of a graft versus host response.
Rituximab is being used in limited cases, and should be considered somewhat "investigational" in this setting. Although it is safe, the response rate is largely unknown. It is a reasonable alternative when traditional therapies are not working.