Assessment of Carfilzomib Treatment Response in Lung Transplant Recipients With Antibody-mediated Rejection.

Autor:	Pham C; Department of Pharmacy, Houston Methodist Hospital, Houston, TX., Pierce BJ; Department of Pharmacy, Houston Methodist Hospital, Houston, TX., Nguyen DT; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX., Graviss EA; Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX.; Department of Surgery, Houston Methodist Hospital, Houston, TX., Huang HJ; Department of Medicine, Houston Methodist Hospital, Houston, TX.
Jazyk:	angličtina
Zdroj:	Transplantation direct [Transplant Direct] 2021 Mar 16; Vol. 7 (4), pp. e680. Date of Electronic Publication: 2021 Mar 16 (Print Publication: 2021).
DOI:	10.1097/TXD.0000000000001131
Abstrakt:	Data supporting the use of carfilzomib (CFZ) for treatment of antibody-mediated rejection (AMR) in lung transplantation in combination with plasmapheresis and intravenous immunoglobulin suggest positive outcomes through donor-specific antibody (DSA) depletion or conversion to noncomplement-activating antibodies. Herein, we describe our center's experience treating AMR with CFZ. Methods: All patients treated with CFZ for AMR from 2014 to 2019 were included. The primary outcome was a positive response to CFZ was defined as: (1) loss of DSA C1q-fixing ability after last CFZ dose; (2) clearance of de novo DSA; or (3) decrease in de novo DSA mean fluorescence intensity of >3000. Results: Twenty-eight patients with 31 AMR episodes were treated with CFZ. A positive response was observed in 74.4% of AMR episodes and 82.1% of patients. This response was driven by loss of complement 1q fixation (70.6%), elimination of class I DSAs (78.6%), and reduction in both classes I (median 2815, 79.5% reduction from baseline) and II DSA mean fluorescence intensity (3171, 37.1%). Conclusions: CFZ shows potential for ameliorating AMR; however, additional studies are needed to define optimal time of administration. Competing Interests: The authors declare no funding or conflicts of interest. (Copyright © 2021 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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