Original Article

Bone Marrow Transplantation (2006) 38, 433–436. doi:10.1038/sj.bmt.1705463; published online 7 August 2006

Post-Transplant Events

Adjuvant rituximab causes prolonged hypogammaglobulinaemia following autologous stem cell transplant for non-Hodgkin's lymphoma

J Shortt1 and A Spencer1

1Department of Clinical Haematology and Bone Marrow Transplantation, Alfred Hospital, Melbourne, Victoria, Australia

Correspondence: Dr J Shortt, Department of Clinical Haematology and Bone Marrow Transplantation, Alfred Hospital, Commercial Road, Prahran, Melbourne, Victoria 3181, Australia. E-mail: jshortt@ausdoctors.net

Received 24 February 2006; Revised 26 June 2006; Accepted 2 July 2006; Published online 7 August 2006.

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Abstract

Rituximab is an anti-CD20 monoclonal antibody that has efficacy in B-cell non-Hodgkin's lymphoma (NHL). Adjuvant immunotherapy with rituximab may reduce relapse rates for high-risk B-cell NHL following high-dose chemotherapy with autologous stem cell transplantation (SCT). However, the potential adverse effects of rituximab on immune reconstitution following SCT are not fully characterized. We performed a retrospective analysis of immunoglobulin (Ig) levels and peripheral blood neutrophil counts in 11 patients who received adjuvant rituximab following autologous SCT for B-cell NHL. Results were compared to a contemporaneous group of 24 patients who received an identical conditioning regimen and autologous SCT for lymphoma, but no adjuvant rituximab. Adjuvant rituximab was associated with a significantly increased incidence of hypogammaglobulinaemia between 12 and 24 months post-SCT, but not neutropenia. Despite suppression of Igs, there were no late or atypical infective complications attributable to rituximab.

Keywords:

rituximab, immunotherapy, NHL, SCT, hypogammaglobulinaemia

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