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Post-Transplant Events

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

Bone Marrow Transplantation volume 42, pages 483–487 (2008)Cite this article

Abstract

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.

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Authors and Affiliations

  1. Department of Medicine, Hematology, University Hospital Basel, Basel, Switzerland

    A Buser, M Stern, C Arber, M Medinger, J Halter, A Rovo, A Tichelli & A Gratwohl

  2. Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland

    A Buser

  3. Department of Oncology, Medical University Clinic, Kantonsspital, Liestal, Switzerland

    G Favre & A Lohri

Authors
  1. A Buser
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  2. M Stern
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  3. C Arber
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  4. M Medinger
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  5. J Halter
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  6. A Rovo
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  7. G Favre
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  8. A Lohri
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  9. A Tichelli
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  10. A Gratwohl
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Correspondence to A Buser.

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Buser, A., Stern, M., Arber, C. et al. Impaired B-cell reconstitution in lymphoma patients undergoing allogeneic HSCT: an effect of pretreatment with rituximab?. Bone Marrow Transplant 42, 483–487 (2008). https://doi.org/10.1038/bmt.2008.229

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  • DOI: https://doi.org/10.1038/bmt.2008.229

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