Consequences of B-cell-depleting therapy: hypogammaglobulinemia and impaired B-cell reconstitution
- 31 May 2018
- journal article
- review article
- Published by Informa UK Limited in Immunotherapy
- Vol. 10 (8), 713-728
- https://doi.org/10.2217/imt-2017-0178
Abstract
Rituximab is a chimeric monoclonal antibody used to treat hematologic and autoimmune diseases by depleting CD20-expressing B cells. Patients may develop hypogammaglobulinemia following treatment, with some demonstrating failure of B-cell recovery. The true frequency of hypogammaglobulinemia and/or impaired B-cell reconstitution post rituximab is unknown due to the lack of prospective studies in different patient cohorts. The clinical significance remains controversial; some patients have recurrent infections while others are relatively asymptomatic. The aim of this review is to describe the prevalence of hypogammaglobulinemia and the associated risk for developing severe infection, in patients with differing underlying clinical conditions treated with rituximab. This may facilitate classification and prognostication of patients who develop these conditions and identify patients who may be at high risk of developing these complications, including those who may benefit from immunoglobulin replacement therapy.Keywords
This publication has 100 references indexed in Scilit:
- Off-label use of rituximab in dermatology: pemphigus treatmentAnais Brasileiros de Dermatologia, 2013
- Common variable immunodeficiency unmasked by treatment of immune thrombocytopenic purpura with RituximabBMC Blood Disorders, 2013
- B cell depletion in immune thrombocytopenia reveals splenic long-lived plasma cellsJCI Insight, 2012
- Long-term safety of rituximab in rheumatoid arthritis: 9.5-year follow-up of the global clinical trial programme with a focus on adverse events of interest in RA patientsAnnals Of The Rheumatic Diseases, 2012
- Impact of Rituximab on Immunoglobulin Concentrations and B Cell Numbers after Cyclophosphamide Treatment in Patients with ANCA-Associated VasculitidesPLOS ONE, 2012
- Immunologic effects of rituximab on the human spleen in immune thrombocytopeniaBlood, 2011
- Good and bad memories following rituximab therapyArthritis & Rheumatism, 2009
- Improvement in patient‐reported outcomes in a rituximab trial in patients with severe rheumatoid arthritis refractory to anti–tumor necrosis factor therapyArthritis Care & Research, 2008
- Increased natural killer cell expression of CD16, augmented binding and ADCC activity to rituximab among individuals expressing the FcγRIIIa-158 V/V and V/F polymorphismBlood, 2007
- Increase of B cell-activating factor of the TNF family (BAFF) after rituximab treatment: insights into a new regulating system of BAFF productionAnnals Of The Rheumatic Diseases, 2007