Combination treatment of bullous pemphigoid with anti-CD20 and anti-CD25 antibodies in a patient with chronic graft-versus-host disease

Bone Marrow Transplant. 2002 Sep;30(5):327-9. doi: 10.1038/sj.bmt.1703654.

Abstract

In this case report we describe a novel treatment with two chimeric monoclonal antibodies (MoAb) targeting the autoimmune B cell clone responsible for bullous pemphigoid (BP) as a manifestation of steroid refractory chronic graft-versus-host disease (GVHD) that developed after unrelated cord blood transplantation. Monitoring the BP-specific circulating antibodies and CD25-expressing activated T lymphocyte subset led us to combine anti-CD20 (Rituximab) mediated B cell ablation with anti-CD25 (Daclizumab) therapy to block CD4(+) T cell help. Complete clinical and serologic response was achieved within 4 weeks of initiation of therapy allowing global immunosuppression to be dramatically reduced.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal / therapeutic use
  • Antigens, CD20 / immunology
  • B-Lymphocytes / drug effects
  • B-Lymphocytes / pathology
  • Child
  • Chronic Disease
  • Cord Blood Stem Cell Transplantation / adverse effects
  • Drug Therapy, Combination
  • Graft vs Host Disease / drug therapy*
  • Humans
  • Male
  • Pemphigoid, Bullous / drug therapy*
  • Receptors, Interleukin-2 / immunology
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antigens, CD20
  • Receptors, Interleukin-2