CD20 monoclonal antibody (rituximab) for therapy of Epstein-Barr virus lymphoma after hemopoietic stem-cell transplantation

After bone marrow transplantation (BMT) using T-cell-depleted marrow from a n unrelated donor or HLA-mismatched related donor, the risk of developing l ymphoproliferative disease associated with the Epstein-Barr virus (EBV) ran ges from 1% to 25%. We have shown that administration of donor-derived EBV- specific cytotoxic T lymphocytes (CTL) is effective prophylaxis and treatme nt for this complication, and we routinely generate CTL for high-risk patie nts. However, EBV lymphoma can occur in recipients of matched-sibling trans plants for whom CTL are unavailable or in patients for whom CTL administrat ion is contraindicated. We report on 3 such patients, who were successfully and safely treated with rituximab, a CD20 monoclonal antibody. The patient s remain disease free 7, 8, and 9 months, respectively, after therapy. We c onclude that CD20 antibody may be a useful alternative treatment strategy i n patients with EBV lymphoma after BMT. (C) 2000 by The American Society of Hematology.