Shortt J, Spencer A
Department of Clinical Haematology and Bone Marrow Transplantation, Alfred Hospital, Melbourne, Victoria, Australia.
Bone Marrow Transplant. 2006 Sep;38(6):433-6. doi: 10.1038/sj.bmt.1705463. Epub 2006 Aug 7.
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.
利妥昔单抗是一种抗CD20单克隆抗体，对B细胞非霍奇金淋巴瘤（NHL）有效。自体干细胞移植（SCT）大剂量化疗后，利妥昔单抗辅助免疫治疗可能降低高危B细胞NHL的复发率。然而，利妥昔单抗对SCT后免疫重建的潜在不良影响尚未完全明确。我们对11例接受自体SCT治疗B细胞NHL后接受利妥昔单抗辅助治疗的患者的免疫球蛋白（Ig）水平和外周血中性粒细胞计数进行了回顾性分析。将结果与同期接受相同预处理方案和自体SCT治疗淋巴瘤但未接受利妥昔单抗辅助治疗的24例患者进行比较。辅助利妥昔单抗与SCT后12至24个月期间低丙种球蛋白血症的发生率显著增加相关，但与中性粒细胞减少无关。尽管Ig受到抑制，但没有可归因于利妥昔单抗的晚期或非典型感染并发症。
