[Alteration in antibody-mediated immunity in patients with rituximab-combined chemotherapy and incidence of herpes zoster].
Rituximab, a chimeric monoclonal antibody against the CD20 protein, has an antineoplastic effect resulting from antibody dependent cellular cytotoxicity (ADCC) and complement-dependent cytotoxicity (CDC). In patients with rituximab-combined chemotherapy, a decline in immunoglobulin can be observed. This is more likely to cause virus reactivation, such as Herpes (H) zoster. However, this fact has not reported in a large-scale study. In order to research immunodeficiency conditions in patients with rituximab-combined therapy, we examined the alteration in immunoglobulin level throughout the treatment among 205 cases with B-cell lymphoma. We also studied the prevalence of H. zoster in those cases. The IgG level throughout the treatment was measured in 89 patients in the research. The median post-chemotherapy IgG level was 41.1% lower than its pre-chemotherapy IgG level. In 58 cases, the IgG level following chemotherapy was below the normal level. In 22 cases, the IgG level dropped to less than half of the pre-chemotherapy level. H. zoster developed in 17 cases (8.3%). There was no significant difference in IgG level between H. zoster-onset cases and non-H. zoster-onset cases. Antibody-mediated immunity can decrease greatly and prolong in cases with rituximab in combination with chemotherapy. Therefore, infection control is considered to be important.
Ito
Kaori
K
Department of Pharmacy, Fujita Health University Hospital, Japan.
Okamoto
Masataka
M
Maruyama
Fumio
F
Handa
Kosuke
K
Yamamoto
Yukiya
Y
Watanabe
Masato
M
Tsuzuki
Motohiro
M
Mizuta
Shuichi
S
Kumazawa
Satomi
S
Ohta
Hideki
H
Nakano
Itsuko
I
Emi
Nobuhiko
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; 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; D006562:Herpes Zoster / Q000209:etiology*; D006801:Humans; D056724:Immunity, Humoral / Q000187:drug effects*; D007074:Immunoglobulin G / Q000097:blood; D007136:Immunoglobulins / Q000032:analysis; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000191:economics / Q000276:immunology; D008297:Male; D008875:Middle Aged; D000069283:Rituximab; D014775:Virus Activation
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D007074:Immunoglobulin G; D007136:Immunoglobulins; D000069283:Rituximab