Adjuvant rituximab causes prolonged hypogammaglobulinaemia following autologous stem cell transplant for non-Hodgkin's lymphoma

Bone Marrow Transplant. 2006 Sep;38(6):433-6. doi: 10.1038/sj.bmt.1705463. Epub 2006 Aug 7.

Abstract

Rituximab is an anti-CD20 monoclonal antibody that has efficacy in B-cell non-Hodgkin's lymphoma (NHL). Adjuvant immunotherapy with rituximab may reduce relapse rates for high-risk B-cell NHL following high-dose chemotherapy with autologous stem cell transplantation (SCT). However, the potential adverse effects of rituximab on immune reconstitution following SCT are not fully characterized. We performed a retrospective analysis of immunoglobulin (Ig) levels and peripheral blood neutrophil counts in 11 patients who received adjuvant rituximab following autologous SCT for B-cell NHL. Results were compared to a contemporaneous group of 24 patients who received an identical conditioning regimen and autologous SCT for lymphoma, but no adjuvant rituximab. Adjuvant rituximab was associated with a significantly increased incidence of hypogammaglobulinaemia between 12 and 24 months post-SCT, but not neutropenia. Despite suppression of Igs, there were no late or atypical infective complications attributable to rituximab.

Publication types

  • Comparative Study

MeSH terms

  • Adjuvants, Pharmaceutic / administration & dosage
  • Adjuvants, Pharmaceutic / adverse effects*
  • Adult
  • Agammaglobulinemia / blood*
  • Agammaglobulinemia / etiology
  • Aged
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Immunotherapy / adverse effects
  • Leukocyte Count
  • Lymphoma, B-Cell / blood*
  • Lymphoma, B-Cell / complications
  • Lymphoma, B-Cell / etiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Rituximab
  • Stem Cell Transplantation* / adverse effects
  • Transplantation, Autologous

Substances

  • Adjuvants, Pharmaceutic
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents
  • Immunoglobulin G
  • Rituximab