Delayed-onset and long-lasting severe neutropenia due to rituximab.
BACKGROUND
Rituximab, a monoclonal antibody, is effective in CD20-positive B-cell lymphoma and is now widely used either as a single agent or in combination with chemotherapy. The antibody's toxicity is generally mild and transient. There are reports of protracted neutropenia in patients treated with rituximab.


METHODS
We report on a patient with Burkitt's lymphoma treated with the hyper-CVAD chemotherapy regimen combined with rituximab. Four weeks after the five months' treatment marked neutropenia and hypogammaglobulinaemia occurred and persisted for one year. Both laboratory findings were not associated with severe infections in our patient.


CONCLUSIONS
Delayed-onset neutropenia is a newly recognised toxicity of rituximab treatment which may last up to one year and be complicated by serious infections.
Hofer
Silvia
S
Department of Medical Oncology, St. Claraspital, Basel, Switzerland. silvia.hofer@claraspital.ch
Viollier
Romaine
R
Ludwig
Christian
C
D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002051:Burkitt Lymphoma / Q000188:drug therapy*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000009:adverse effects*; D003907:Dexamethasone / Q000009:adverse effects*; D004317:Doxorubicin / Q000009:adverse effects*; D018023:HIV Seronegativity; D006801:Humans; D008297:Male; D009503:Neutropenia / Q000209:etiology*; D000069283:Rituximab; D013997:Time Factors; D014750:Vincristine / Q000009:adverse effects*
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide