[Immunologic changes in diffuse large B-cell lymphomas after rituximab-CHOP treatment: own data and review of the literature].
BACKGROUND
Rituximab treatment may induce a long-term B-cell depletion, which can be accompanied with an increased infection risk.


OBJECTIVE
To examine the changes of the white blood cell, CD19+ B-cell and CD4+ T-cell counts and the levels of immunoglobulin G, A, M after rituximab containing chemotherapy and to explore the infectious complications in our patients and review of the literature.


METHODS
Thirty-five diffuse large B-cell lymphoma patients were examined, who were treated with rituximab-cyclophosphamide-vincristine-doxoribicine-prednisolone (R-CHOP). The B- and T-cell populations were analyzed with flow-cytometry while the immunoglobulin levels were measured by nephelometry.


RESULTS
CD19+ B-lymphocytes were undetectable after the treatment and their count only increased from the post-therapeutic 12th month. Infection did not occur in this group of patients.


CONCLUSIONS
Rituximab induced B-cell depletion was appreciable also in this group of patients, while serious or unexpected infection did not occur. Increased infectious risk primarily can be observed after long-term, maintenance rituximab treatment.
Debreceni Egyetem, Orvos- és Egészségtudományi Centrum Belgyógyászati Intézet, Hematológia Tanszék Debrecen Nagyerdei krt. 98. 4032. zsocogo@gmail.com
Zsófia
Z
Simon
Arpád
A
Illés
Zsófia
Z
Miltényi
Ferenc
F
Magyari
László
L
Váróczy
Nikolett
N
Péter
Lajos
L
Gergely
D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005434:Flow Cytometry; D006509:Hepatitis B / Q000175:diagnosis; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D015994:Incidence; D007239:Infections / Q000175:diagnosis / Q000209:etiology; D007968:Leukoencephalopathy, Progressive Multifocal / Q000175:diagnosis / Q000209:etiology; D018655:Lymphocyte Count; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications; D011241:Prednisone / Q000008:administration & dosage; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D000069283:Rituximab; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D013997:Time Factors; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
D058846:Antibodies, Monoclonal, Murine-Derived; D007136:Immunoglobulins; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone