Intermediate doses of rituximab used as adjuvant therapy in refractory XXXX .

@entity1 @entity7271 @entity2225 @entity230 @entity3137 @entity288
BACKGROUND: Rituximab, a monoclonal anti- @entity2225 antibody, has been used with encouraging results in @entity7271 . We describe herein refractory cases of @entity7271 (n = 23) and @entity7271 foliaceus (n = 1) treated with rituximab in addition to @entity230 and immunosuppressants. AIMS: To assess the response to treatment, the duration of clinical remission, serology of the response and adverse effects of rituximab in @entity7271 @entity1 . METHODS: We recorded observations of 24 @entity1 with @entity7271 having either refractory disease in spite of high dose of @entity230 and immunosuppressants, corticosteroid-dependent disease, strong contraindications to @entity288 , or severe disease. The @entity1 were treated with infusions of one injection per week for three consecutive weeks of 375 mg of rituximab per m    of body-surface area. One similar infusion was repeated after 3 months of 3 rd dose. We observed the clinical outcome after 6 months of 3 rd dose of rituximab and looked for complete healing of @entity3137 (complete remission). OBSERVATIONS: After follow-up of 7-24 months, five @entity1 showed only partial improvement while 19 of 24 @entity1 had a complete remission 3 months after rituximab. Of these 19 @entity1 , 12 @entity1 achieved complete remission and are off all systemic therapy, and the rest are continuing with no or low dose of @entity230 with immunosuppressants. Two @entity1 relapsed after initial improvement; one was given moderate dose of oral @entity230 and immunosuppressant and the other was given repeat single dose of rituximab to control relapse. CONCLUSION: Rituximab is able to induce a prolonged clinical remission in @entity7271 after a single course of four infusions. The high cost and limited knowledge of long term adverse effects are limitations to the use of this biologic agent.
