Table 2. Immunosuppression tapering... | American Society of Hematology

Table 2.

Immunosuppression tapering

Patient	Treatment of last rejection episode	Time from last rejection episode to BLPD onset (mo)	IS at BLPD onset	Reduction of IS	T-cell count before anti–IL-6 (CD3/μL)	Anti-EBV antibodies before treatment	Anti-EBV antibodies after treatment (day 30)
1	3 Pulse steroids	3	Steroids, CsA, azathioprine	Increase 33% steroids Stop azathioprine Reduction 50% CsA	660	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁻	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁻
2	Pulse steroids, ATG, OKT3	10	Steroids, CsA	Reduction 50% CsA	ND	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺⁺
3	Pulse steroids	103	Steroids, CsA, azathioprine	Stop steroids Stop azathioprine	ND	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁻ IgG EA⁺	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁻ IgG EA⁻
4	None	—	Steroids, CsA, azathioprine	Stop azathioprine Reduction 50% CsA	227	IgM VCA⁺ IgG VCA⁺⁺⁺ IgG EBNA⁻	ND
5	3 Pulse steroids	1.5	Steroids, CsA, azathioprine	Stop CsA Stop azathioprine	1 074	IgG VCA⁻	IgG VCA⁻
6	None	—	Steroids, FK506	Stop FK506	309	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺
7	ATG	11	Steroids, CsA	Reduction 50% steroids Reduction 50% CsA	ND	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺
8	Pulse steroids	2.5	Steroids, FK506, azathioprine	Stop azathioprine Stop FK506	187	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺	IgM VCA⁻ IgG VCA⁺⁺ IgG EBNA⁺⁺
9	None	—	Steroids, CsA	Stop CsA	322	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺⁺⁺ IgG EA⁺⁺	IgM VCA⁻ IgG VCA⁺⁺ IgG EBNA⁺⁺⁺ IgG EA⁺
10	Pulse steroids	48	Steroids, CsA, azathioprine	Stop CsA Stop azathioprine Reduction 50% steroids	ND	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺IgG EA⁺⁺	ND
11	None	—	Steroids, CsA, mycophenolate	Stop CsA Reduction 50% mycophenolate	ND	IgM VCA⁺ IgG VCA⁺ IgG EBNA⁺	IgM VCA⁺⁺⁺ IgG VCA⁺⁺⁺ IgG EBNA⁺⁺⁺
12	Pulse steroids	0.5	Steroids, CsA, azathioprine	Stop CsA Stop azathioprine	840	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁻ IgG EA⁺	IgM VCA⁻ IgG VCA⁻ IgG EBNA⁻ IgG EA:ND

Patient	Treatment of last rejection episode	Time from last rejection episode to BLPD onset (mo)	IS at BLPD onset	Reduction of IS	T-cell count before anti–IL-6 (CD3/μL)	Anti-EBV antibodies before treatment	Anti-EBV antibodies after treatment (day 30)
1	3 Pulse steroids	3	Steroids, CsA, azathioprine	Increase 33% steroids Stop azathioprine Reduction 50% CsA	660	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁻	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁻
2	Pulse steroids, ATG, OKT3	10	Steroids, CsA	Reduction 50% CsA	ND	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺⁺
3	Pulse steroids	103	Steroids, CsA, azathioprine	Stop steroids Stop azathioprine	ND	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁻ IgG EA⁺	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁻ IgG EA⁻
4	None	—	Steroids, CsA, azathioprine	Stop azathioprine Reduction 50% CsA	227	IgM VCA⁺ IgG VCA⁺⁺⁺ IgG EBNA⁻	ND
5	3 Pulse steroids	1.5	Steroids, CsA, azathioprine	Stop CsA Stop azathioprine	1 074	IgG VCA⁻	IgG VCA⁻
6	None	—	Steroids, FK506	Stop FK506	309	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺
7	ATG	11	Steroids, CsA	Reduction 50% steroids Reduction 50% CsA	ND	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺
8	Pulse steroids	2.5	Steroids, FK506, azathioprine	Stop azathioprine Stop FK506	187	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺	IgM VCA⁻ IgG VCA⁺⁺ IgG EBNA⁺⁺
9	None	—	Steroids, CsA	Stop CsA	322	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺⁺⁺ IgG EA⁺⁺	IgM VCA⁻ IgG VCA⁺⁺ IgG EBNA⁺⁺⁺ IgG EA⁺
10	Pulse steroids	48	Steroids, CsA, azathioprine	Stop CsA Stop azathioprine Reduction 50% steroids	ND	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁺IgG EA⁺⁺	ND
11	None	—	Steroids, CsA, mycophenolate	Stop CsA Reduction 50% mycophenolate	ND	IgM VCA⁺ IgG VCA⁺ IgG EBNA⁺	IgM VCA⁺⁺⁺ IgG VCA⁺⁺⁺ IgG EBNA⁺⁺⁺
12	Pulse steroids	0.5	Steroids, CsA, azathioprine	Stop CsA Stop azathioprine	840	IgM VCA⁻ IgG VCA⁺ IgG EBNA⁻ IgG EA⁺	IgM VCA⁻ IgG VCA⁻ IgG EBNA⁻ IgG EA:ND

IS, immunosuppression; CsA, cyclosporin A; ATG, antithymoglobulin.