title: B cell reconstitution after rituximab treatment of lymphoma recapitulates B cell ontogeny.
abstract: The long-term immunologic effects of B cell depletion with rituximab and the characteristics of the reconstituting B cell pool in lymphoma patients are not well defined, despite the widespread usage of this therapy. Here we report that during the B cell reconstitution phase a majority of the peripheral blood B cells have an immature transitional phenotype (47.8%+/-25.2% vs. 4.4%+/-2.4% for normal controls, p<0.0001), similar to what has been described during the original ontogeny of the immune system and following bone marrow transplantation. Moreover, the recovery of the CD27+ memory B cell pool was delayed compared to normal B cell ontogeny, remaining below normal controls at 1 year post-rituximab (4.4%+/-3% vs. 31%+/-7%, p<0.0001). Expansion of functionally immature B cells and decreased memory B cells may contribute to an immunodeficient state in patients recovering from rituximab mediated B cell depletion, particularly with repeated treatment.
authors.affiliation: Department of Medicine, Division of Clinical Immunology and Rheumatology, James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA. jennifer_anolik@urmc.rochester.edu
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Anolik
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Friedberg
authors.forename: Bo
authors.initials: B
authors.lastname: Zheng
authors.forename: Jennifer
authors.initials: J
authors.lastname: Barnard
authors.forename: Teresa
authors.initials: T
authors.lastname: Owen
authors.forename: Emily
authors.initials: E
authors.lastname: Cushing
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kelly
authors.forename: Eric C B
authors.initials: EC
authors.lastname: Milner
authors.forename: Richard I
authors.initials: RI
authors.lastname: Fisher
authors.forename: Iñaki
authors.initials: I
authors.lastname: Sanz
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000166:cytology / Q000276:immunology* / Q000473:pathology*; D002454:Cell Differentiation / Q000276:immunology*; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D016393:Lymphoma, B-Cell / Q000276:immunology / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D000069283:Rituximab
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab