title: Adjuvant rituximab causes prolonged hypogammaglobulinaemia following autologous stem cell transplant for non-Hodgkin's lymphoma.
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.
authors.affiliation: Department of Clinical Haematology and Bone Marrow Transplantation, Alfred Hospital, Melbourne, Victoria, Australia. jshortt@ausdoctors.net
authors.forename: J
authors.initials: J
authors.lastname: Shortt
authors.forename: A
authors.initials: A
authors.lastname: Spencer
mesh_terms: D000277:Adjuvants, Pharmaceutic / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000361:Agammaglobulinemia / Q000097:blood* / Q000209:etiology; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007167:Immunotherapy / Q000009:adverse effects; D007958:Leukocyte Count; D016393:Lymphoma, B-Cell / Q000097:blood* / Q000150:complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000069283:Rituximab; D033581:Stem Cell Transplantation / Q000009:adverse effects; D014182:Transplantation, Autologous
chemical_list: D000277:Adjuvants, Pharmaceutic; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D007074:Immunoglobulin G; D000069283:Rituximab