A pilot study of combining rituximab and low-dose (1.0Gy) total nodal irradiation in treatment of extensive chronic graft-versus-host disease

This study is testing a combination treatment — a single dose of the drug rituximab plus a low dose of radiation to the lymph nodes (total nodal irradiation) — for people who have developed a serious complication called chronic graft-versus-host disease (cGVHD) after a bone marrow transplant. cGVHD happens when the donor immune cells attack the recipient's body, particularly the skin and other organs. Standard steroid-based treatments don't always work well, and this study is exploring whether this combination approach is safe and effective. You may be eligible if: - You have had a bone marrow (allogeneic stem cell) transplant - You have active, extensive skin involvement from chronic graft-versus-host disease - Your condition has not responded adequately to standard immune-suppressing medications You may NOT be eligible if: - You have permanent, irreversible organ damage from cGVHD - You have an uncontrolled active infection - You have severely low blood counts (severe cytopenias) Talk to your doctor about whether this trial might be right for you.