Nishio Mitsufumi, Endo Tomoyuki, Fujimoto Katsuya, Yamamoto Satoshi, Obara Masato, Yamaguchi Keisuke, Takeda Yukari, Goto Hideki, Kasahara Ikumi, Sato Norihiro, Koike Takao
Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Eur J Haematol. 2009 Feb;82(2):143-7. doi: 10.1111/j.1600-0609.2008.01174.x. Epub 2008 Nov 6.
Recent studies have indicated that patients who receive stem cell transplantation (SCT) and rituximab demonstrate an increased risk of developing hypogammaglobulinemia. Such hypogammaglobulinemia has been found to be due to delayed recovery of memory B cells with an abnormal cell marker expression and impaired immunoglobulin production in vitro. However, no predictive factors for the levels of immunoglobulin after autologous SCT and rituximab therapy have been reported. The aim of this study is to clarify the relationships between the FCGR3A-158V/F genotype and the levels of serum immunoglobulin after SCT.
A total of 24 non-Hodgkin's lymphoma (NHL) patients received autologous SCT with an adjuvant rituximab. The FCGR3A-158V/F genotype was determined in these patients. We also included ten NHL patients who received an identical conditioning regimen and autologous SCT but no rituximab as control patients.
The levels of IgG were significantly lower in FCGR3A-158F homozygous patients (n = 9) in comparison to those in FCGR3A-158V carriers (n = 15). Moreover, the levels of IgG and IgA of FCGR3A-158F homozygous patients, but not those of FCGR3A-158V carriers, were significantly lower than those of control patients.
The genotype of FCGR3A determines not only the response to rituximab, but also the levels of immunoglobulin after SCT and an adjuvant rituximab.
近期研究表明,接受干细胞移植(SCT)和利妥昔单抗治疗的患者发生低丙种球蛋白血症的风险增加。已发现这种低丙种球蛋白血症是由于记忆B细胞恢复延迟,伴有异常的细胞标志物表达以及体外免疫球蛋白产生受损。然而,尚未有关于自体SCT和利妥昔单抗治疗后免疫球蛋白水平的预测因素的报道。本研究的目的是阐明FCGR3A - 158V/F基因型与SCT后血清免疫球蛋白水平之间的关系。
共有24例非霍奇金淋巴瘤(NHL)患者接受了自体SCT并辅助使用利妥昔单抗。测定了这些患者的FCGR3A - 158V/F基因型。我们还纳入了10例接受相同预处理方案和自体SCT但未使用利妥昔单抗的NHL患者作为对照。
与FCGR3A - 158V携带者(n = 15)相比,FCGR3A - 158F纯合子患者(n = 9)的IgG水平显著降低。此外,FCGR3A - 158F纯合子患者的IgG和IgA水平显著低于对照患者,而FCGR3A - 158V携带者则不然。
FCGR3A的基因型不仅决定了对利妥昔单抗的反应,还决定了SCT及辅助使用利妥昔单抗后免疫球蛋白的水平。