Research Article

Antibody-Mediated Rejection: Pathogenesis, Prevention, Treatment, and Outcomes

Table 1

Published studies of the use of bortezomib in AMR [11].

StudyNPatientsTreatmentOutcome

Wade et al. 2009 [40]5Renal transplant with mixed AMR and ACRBortezomib 1.3 mg/m2/dose × 4(i) Prompt AMR and ACR reversal
(ii) Significant decrease in DSA levels

Tanriover et al. 2008 [38]6Kidney/kidney pancreas transplant with mixed AMR and ACRSame as above(i) Prompt rejection reversal marked and prolonged reductions in DSA levels
(ii) >50% decrease in DSA levels within 14 days and suppression for up to 5 months

Celik et al. 2009 [37]2Positive crossmatch renal transplant recipient with AMRBortezomib 1.3 mg/m2/dose on days 1, 4, 8, 11
Daily plasmapheresis and IVIG
(i) Decrease HLA allospecificities
(ii) Decrease in number of plasma cells in bone marrow

Faguer et al. 2010 [39]4Renal transplant recipients with AMR and persistently elevated DSABortezomib 1.3 mg/m2/dose × 4No significant decrease in DSA within 150 days post treatment

Wade et al. 2009 [40]11Living donor renal transplant patients with anti-HLA alloantibodiesBortezomib 1.3 mg/m2/dose with methylprednisolone 250 mg on days 1, 4, 8, 11 2–4 sessions of plasmapheresis 1 dose of rituximab (6 patients)(i) Reduced DSA and non-DSA levels
(ii) Stable graft function 4 months post treatment

Faguer et al. 2010 [40]2Living donor renal transplantBortezomib 1.3 mg/m2/dose × 4 Ongoing plasmapheresis, rituximab, intravenous steroids(i) Immediate significant reduction in DSA
(ii) Stable graft function at 6 months post treatment