title: Rituximab therapy increased post-transplant cytomegalovirus complications in Non-Hodgkin's lymphoma patients receiving autologous hematopoietic stem cell transplantation.
abstract: 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.
authors.affiliation: Division of Hemato-Oncology, Department of Medicine, Chia-Yi Christian Hospital, Chia-Yi, Taiwan, ROC.
authors.forename: Ming-Yang
authors.initials: MY
authors.lastname: Lee
authors.forename: Tzeon-Jye
authors.initials: TJ
authors.lastname: Chiou
authors.forename: Liang-Tsai
authors.initials: LT
authors.lastname: Hsiao
authors.forename: Muh-Hwa
authors.initials: MH
authors.lastname: Yang
authors.forename: Pang-Chan
authors.initials: PC
authors.lastname: Lin
authors.forename: Say-Bee
authors.initials: SB
authors.lastname: Poh
authors.forename: Chueh-Chuan
authors.initials: CC
authors.lastname: Yen
authors.forename: Jin-Hwang
authors.initials: JH
authors.lastname: Liu
authors.forename: Hao-Wei
authors.initials: HW
authors.lastname: Teng
authors.forename: Ta-Chung
authors.initials: TC
authors.lastname: Chao
authors.forename: Wei-Shu
authors.initials: WS
authors.lastname: Wang
authors.forename: Po-Min
authors.initials: PM
authors.lastname: Chen
mesh_terms: 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
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab