Rituximab therapy increased post-transplant cytomegalovirus complications in Non-Hodgkin's lymphoma patients receiving autologous hematopoietic stem cell transplantation.
The use of monoclonal antibody, rituximab, had been reported to be associated with some severe viral infections. The inference of rituximab therapy and post-transplant cytomegalovirus (CMV) infectious complications in non-Hodgkin's lymphoma (NHL) patients is still unclear now. From 2002 to 2005, 46 patients with relapsed indolent or high-risk aggressive B cell NHL who received rituximab (17 patients) or not (29 patients) before autologous hematological stem cell transplantation (HSCT) in one institute were retrospectively analyzed for the risk factors of CMV complications after transplantation. Pre-transplant and post-transplant CMV infectious conditions, conditioning regimens, transplant types, and post-transplant complications were recorded. Post-transplant infectious complications were followed up until 6 months after transplantation. Seventeen of 46 patients received rituximab before HSCT. Three of them suffered from CMV infection and two of them developed CMV disease. All of the patients with CMV disease recovered after ganciclovir and CMV-specific immunoglobulin therapy. Twenty-nine of 46 patients without rituximab treatment before HSCT did not have CMV complications after HSCT. The risks to develop CMV infections after autologous HSCT were higher in rituximab-treated patients (17.6% vs 0%, p = 0.045, Fisher exact test, two-sided). The risks to develop CMV diseases had higher trend with rituximab therapy than without rituximab therapy (11.7% vs 0%, p = 0.131, Fisher exact test, two-sided). The NHL patients receiving rituximab therapy had higher risk to develop CMV infectious complications after autologous HSCT.
Lee
Ming-Yang
MY
Division of Hemato-Oncology, Department of Medicine, Chia-Yi Christian Hospital, Chia-Yi, Taiwan, ROC.
Chiou
Tzeon-Jye
TJ
Hsiao
Liang-Tsai
LT
Yang
Muh-Hwa
MH
Lin
Pang-Chan
PC
Poh
Say-Bee
SB
Yen
Chueh-Chuan
CC
Liu
Jin-Hwang
JH
Teng
Hao-Wei
HW
Chao
Ta-Chung
TC
Wang
Wei-Shu
WS
Chen
Po-Min
PM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D058846:Antibodies, Monoclonal, Murine-Derived; D003131:Combined Modality Therapy; D003586:Cytomegalovirus Infections / Q000453:epidemiology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D000069283:Rituximab; D014182:Transplantation, Autologous
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab