MP72-03 SERUM BAFF LEVELS AND B CELL SUBSETS IN DIFFERENT LYMPHOID ORGANS AFTER RITUXIMAB ADMINISTRATION: ITS ASSOCIATION WITH CLINICAL OUTCOMES

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery II1 Apr 2014MP72-03 SERUM BAFF LEVELS AND B CELL SUBSETS IN DIFFERENT LYMPHOID ORGANS AFTER RITUXIMAB ADMINISTRATION: ITS ASSOCIATION WITH CLINICAL OUTCOMES Mitsuru Saito, Shigeru Satoh, Kazuyuki Numakura, Mingguo Huang, Hiroshi Tsuruta, Susumu Akihama, Takamitsu Inoue, Shintaro Narita, Norihiko Tsuchiya, and Tomonori Habuchi Mitsuru SaitoMitsuru Saito More articles by this author , Shigeru SatohShigeru Satoh More articles by this author , Kazuyuki NumakuraKazuyuki Numakura More articles by this author , Mingguo HuangMingguo Huang More articles by this author , Hiroshi TsurutaHiroshi Tsuruta More articles by this author , Susumu AkihamaSusumu Akihama More articles by this author , Takamitsu InoueTakamitsu Inoue More articles by this author , Shintaro NaritaShintaro Narita More articles by this author , Norihiko TsuchiyaNorihiko Tsuchiya More articles by this author , and Tomonori HabuchiTomonori Habuchi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2242AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Rituximab (RIT), anti-CD20 antibody, has been applied to kidney transplantation because of its potent B-cell depleting effect. Although CD20+ cells in peripheral blood (PB) and spleen are consistently depleted in patients receiving RIT, the clinical effects are heterogeneous, probably related to differences in the depleting effects of secondary lymphoid organs (SLOs), such as peripheral lymph nodes (LNs). Meanwhile, B cell activation factor of the TNF family (BAFF) promotes B cell development and antibody secretion, and also serum BAFF levels increase after RIT administration. The aim of this study was to investigate the relationship between serum BAFF levels and B cell subsets in different lymphoid organs after RIT administration and its association with clinical outcomes. METHODS Since April 2005, 50 patients with immunological high risks [ABO-incompatible (ABOI) or donor specific anti-HLA antibody (DSA) positive or both] received a single dose of RIT with 200 mg/body at 3 weeks before kidney transplantation. They received 3 to 4 sessions of apheresis prior to transplantation. The induction immunosuppressive therapy was consisted of tacrolimus, MMF, steroid, and basiliximab. In all patients, the several pelvic LNs were dissected at the time of transplantation. Of those, 2 ABOI (induction period of RIT) and 6 DSA positive patients received splenectomy concurrently with transplantation. Immunohistochemical intensity of B cell subsets (CD20, CD27, CD79a, and CD138) in both LN and spleen was scored. Serum BAFF levels at day -7, 7, and 28 post-transplant were measured by ELISA. RESULTS Acute antibody-mediated rejection (AAMR) developed in 9 patients (19%) in this series. The intensity score of CD138 in LNs was significantly higher in AMR patients (p<0.01) than those in non-AMR patients. No significant difference was found in the intensity scores of all B cell subsets in spleen among the patients with or without AMR. The serum BAFF levels at day -7 (p<0.01), 7 (p<0.05), and 28 (p<0.01) post-transplantation were significantly lower in AMR patients than in non-AMR patients. The existence of DSA before transplant, the intensity score of CD138 in LNs, and low serum BAFF level at 7 days before transplant were significantly associated with the occurrence of AAMR. CONCLUSIONS In immunological high risk kidney transplant recipients receiving RIT before transplant, the plasma cell intensity in LNs and low serum BAFF level were risk factors of AAMR. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e824 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Mitsuru Saito More articles by this author Shigeru Satoh More articles by this author Kazuyuki Numakura More articles by this author Mingguo Huang More articles by this author Hiroshi Tsuruta More articles by this author Susumu Akihama More articles by this author Takamitsu Inoue More articles by this author Shintaro Narita More articles by this author Norihiko Tsuchiya More articles by this author Tomonori Habuchi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...