title: Kinetics of hematogones in bone marrow samples from patients with non-Hodgkin lymphomas treated with rituximab-containing regimens: a flow cytometric study.
abstract: Treatment with rituximab, either alone or in combination with antiblastic drugs, causes significant depletion of circulating B-lymphocytes and modifications of B cell maturation in the bone marrow. In the present study, we analyzed the kinetics of hematogones in bone marrow samples from 55 patients suffering from non-Hodgkin lymphomas and treated with rituximab-containing regimens. Maturation arrest at the level of stage 2 hematogones, along with complete depletion of naïve, mature B-lymphocytes, was observed as short-term effects (2 months after completion of chemo-immunotherapy). Further bone marrow samples, obtained 12 months after the last rituximab infusion in 21 patients undergoing long-term follow-up and treated with rituximab maintenance therapy, showed complete normalization of B-lymphocyte ontogeny. Hypogammaglobulinemia developed in 26 patients, and was still observed in nine of the 21 patients undergoing long-term follow-up. Our study provides novel data on hematogone kinetics in the setting of patients with non-Hodgkin lymphomas treated with chemo-immunotherapy containing rituximab and with rituximab maintenance. Our observations show that hypogammaglobulinemia can persist in a significant percentage of patients, despite complete recovery of B-lymphocyte ontogeny.
authors.affiliation: Division of Hematology, Department of Clinical and Experimental Medicine, Santa Chiara Hospital, University of Pisa, 56126, Pisa, Italy, giovannicarulli@alice.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Carulli
authors.forename: Virginia
authors.initials: V
authors.lastname: Ottaviano
authors.forename: Paola
authors.initials: P
authors.lastname: Sammuri
authors.forename: Cristiana
authors.initials: C
authors.lastname: Domenichini
authors.forename: Valentina
authors.initials: V
authors.lastname: Guerri
authors.forename: Martina
authors.initials: M
authors.lastname: Rousseau
authors.forename: Eugenio M
authors.initials: EM
authors.lastname: Ciancia
authors.forename: Elena
authors.initials: E
authors.lastname: Ciabatti
authors.forename: Mario
authors.initials: M
authors.lastname: Petrini
mesh_terms: D000328:Adult; D000361:Agammaglobulinemia / Q000097:blood / Q000209:etiology; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000378:metabolism / Q000473:pathology; D001853:Bone Marrow / Q000473:pathology*; D001854:Bone Marrow Cells / Q000378:metabolism / Q000473:pathology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007132:Immunoglobulin Isotypes / Q000097:blood; D016130:Immunophenotyping; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D000069283:Rituximab / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D007132:Immunoglobulin Isotypes; D000069283:Rituximab