Late-onset neutropenia in patients with rheumatoid arthritis after treatment with rituximab

J Rheumatol. 2014 May;41(5):858-61. doi: 10.3899/jrheum.130526. Epub 2014 Mar 15.

Abstract

Objective: Late-onset neutropenia (LON) is an adverse effect of rituximab (RTX) in hematological malignancies, a finding that was recently reported in rheumatoid arthritis (RA). The aim of our study was to estimate its incidence in RA.

Methods: We retrospectively reviewed complete blood (cell) count of patients with RA who received RTX between October 2007 and July 2011 to identify neutropenia (≤ 1.5 × 10(9)) up to 12 months following RTX.

Results: One hundred eight patients received RTX, median age 64 years (range 25-86). A total of 237 cycles were given. Five patients developed LON after a median of 151 days (71-184). Two developed pneumonia.

Conclusion: LON occurs infrequently after RTX, but can present with infection.

Keywords: ADVERSE EFFECTS; BIOLOGICAL THERAPY; NEUTROPHILS; RHEUMATOID ARTHRITIS.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Murine-Derived / administration & dosage
  • Antibodies, Monoclonal, Murine-Derived / adverse effects*
  • Antirheumatic Agents / administration & dosage
  • Antirheumatic Agents / adverse effects*
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / drug therapy*
  • Blood Cell Count
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neutropenia / chemically induced*
  • Opportunistic Infections / complications
  • Remission, Spontaneous
  • Retrospective Studies
  • Rituximab
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Antirheumatic Agents
  • Rituximab