Impaired B-cell reconstitution in lymphoma patients undergoing allogeneic HSCT: an effect of pretreatment with rituximab?

被引：16

作者：

Buser, A. ^{[1
,2
]}

Stern, M. ^{[2
]}

Arber, C. ^{[2
]}

Medinger, M. ^{[2
]}

Halter, J. ^{[2
]}

Rovo, A. ^{[2
]}

Favre, G. ^{[3
]}

Lohri, A. ^{[3
]}

Tichelli, A. ^{[2
]}

Gratwohl, A. ^{[2
]}

机构：

[1] Swiss Red Cross, Ctr Blood Transfus, CH-4031 Basel, Switzerland

[2] Univ Basel Hosp, Dept Med, CH-4031 Basel, Switzerland

[3] Med Univ Clin, Kantonsspital, Dept Oncol, Liestal, Switzerland

来源：

BONE MARROW TRANSPLANTATION | 2008年 / 42卷 / 07期

关键词：

allogeneic transplantation; lymphoma; rituximab;

D O I：

10.1038/bmt.2008.229

中图分类号：

Q6 [生物物理学];

学科分类号：

071011 ;

摘要：

Allogeneic hematopoietic SCT (HSCT) is increasingly considered an option in refractory or relapsing lymphoma. Today, most patients with B-cell lymphoma are treated with the monoclonal anti-CD20 antibody rituximab before HSCT. We hypothesized that prior therapy with rituximab might alter immune reconstitution after allogeneic transplantation due to in vivo depletion of B cells at the time of graft infusion. We studied B-cell immune reconstitution in 12 patients with lymphoma receiving rituximab 1-12 months before HSCT. Compared to an age- and sex-matched population of patients transplanted for myeloid malignancies, lymphoma patients with rituximab pretreatment showed significantly reduced B-cell counts at time of HSCT at + 3, + 6 and + 12 months; B-cell counts reached values comparable to controls only 24 months after HSCT. In parallel, levels of immunoglobulins were markedly reduced for up to 2 years post transplant in patients with prior rituximab treatment. Two patients suffered from severe late bacterial infections to which the impaired humoral immunity may have contributed. In contrast, T- and NK-cell reconstitution was not different compared to control patients. In conclusion, B-cell reconstitution can be significantly delayed in allogeneic HSCT recipients with prior rituximab treatment. Rituximab appears to have clinical consequences beyond the immediate early post-transplant period.

引用

页码：483 / 487

页数：5

共 12 条

[1] Septic polyarthritis with Ureaplasma urealyticum in a patient with prolonged agammaglobulinemia and B-cell aplasia after allogeneic HSCT and rituximab pretreatment [J].