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Maintenance rituximab after autologous stem cell transplant for high-risk B-cell lymphoma induces prolonged and severe hypogammaglobulinemia

Bone Marrow Transplantation volume 35, pages 207–208 (2005)Cite this article

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Rituximab is a chimeric CD20 antibody that has been found to be effective for the treatment of B-cell lymphoma. It has a good safety profile and, hence, has been incorporated into many chemotherapeutic regimens for patients with B-cell lymphoma. We recently reported severe and prolonged IgM deficiency in myeloma patients who received rituximab infusion after autologous stem cell transplant (ASCT).1 We observed increased infection rates in these patients. Patients with myeloma, however, usually have contracted B-cell repertoires. They already have depressed normal immunoglobulin levels even prior to any therapy. Therefore, the contracted B-cell repertoire may partly be responsible for the immunoglobulin deficiency. Here, we present data on patients with B-cell lymphoma who received rituximab after ASCT for high-risk disease to determine if immunoglobulin deficiency also occurs in these patients who were not previously immunoglobulin deficient.

Nine patients (seven men, two women) with high-risk B-cell lymphoma were evaluated. Their diagnoses were: advanced mantle cell lymphoma in first complete remission (CR1) (6), Stage IV diffuse large cell lymphoma in CR1 (1) and relapsed high-grade lymphoma in CR2 (2). The median age was 66 years (range 38–72 years). CR was achieved using R-CHOP (8) or R-DHAP (1) and autologous hematopoietic stem cells were harvested during hematopoietic recovery from the last course of chemoimmunotherapy. Each patient received intravenous melphalan (200 mg/m2) prior to the infusion of autologous stem cells of at least 2 × 106/kg CD34+ cells. All patients received a rituximab infusion (375 mg/m2) every 3 months starting D+100 for a total of 2 years or until disease relapse.

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References

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Authors and Affiliations

  1. Division of Hematology and Oncology, Texas Tech University Health Sciences Center, Amarillo and Biotherapy and Stem Cell Transplant Program, Don and Sybil Harrington Cancer Center, TX, USA

    S H Lim, Y Zhang, Z Wang, W V Esler, D Beggs, B Pruitt, P Hancock & M Townsend

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  1. S H Lim
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  2. Y Zhang
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  3. Z Wang
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  4. W V Esler
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  5. D Beggs
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  6. B Pruitt
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  7. P Hancock
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  8. M Townsend
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Lim, S., Zhang, Y., Wang, Z. et al. Maintenance rituximab after autologous stem cell transplant for high-risk B-cell lymphoma induces prolonged and severe hypogammaglobulinemia. Bone Marrow Transplant 35, 207–208 (2005). https://doi.org/10.1038/sj.bmt.1704742

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