Late onset neutropenia and immunoglobulin suppression of the patients with malignant lymphoma following autologous stem cell transplantation with rituximab

Intern Med. 2009;48(1):57-60. doi: 10.2169/internalmedicine.48.1368. Epub 2009 Jan 1.

Abstract

Background: Recently, decrease of immunoglobulin concentrations or neutrophil counts were reported in some cases several months after administration of rituximab. We examined a number of episodes of late onset neutropenia or immunoglobulin decrease in patients with malignant lymphoma who were in complete remission following autologous transplantation with or without rituximab.

Method: Patients with follicular lymphoma and diffuse large B cell lymphoma transplanted with or without rituximab in our institutes were analyzed. Immunoglobulin concentrations and neutrophil counts after transplantation, both with and without rituximab were measured serially.

Results: Four weeks after transplantation, blood samples revealed lower concentrations of IgG and IgA in the rituximab group than in the non-rituximab group. Neutrophil numbers did not fall below 0.5x10(9) /L four weeks or more after transplantation in the non-rituximab group. Neutrophil numbers dropped below 0.5x10(9) /L in 6 of 14 cases in the rituximab group.

Conclusion: Although the present study was retrospective and disease composition and pre-transplantation regimens differed between the two groups, the addition of rituximab to autologous transplantation might bring about a decrease of immunoglobulin levels and transient LON.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal, Murine-Derived
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Immunoglobulins / biosynthesis
  • Immunoglobulins / blood*
  • Lymphoma / blood*
  • Lymphoma / drug therapy
  • Lymphoma / surgery*
  • Male
  • Middle Aged
  • Neutropenia / blood*
  • Neutropenia / chemically induced
  • Retrospective Studies
  • Rituximab
  • Transplantation, Autologous

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Immunoglobulins
  • Rituximab