Dong Linjie, Yan Lin, Li Yi, Li Mei, Feng Weihua, Li Xiaoqiong, Yue Jiaxi, Zhang Erdi, Luo Yao, Bai Yangjuan
Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Laboratory Medicine, Meishan City People's Hospital, Meishan, Sichuan, China.
Front Immunol. 2024 Nov 25;15:1513303. doi: 10.3389/fimmu.2024.1513303. eCollection 2024.
RTX was initially used for non-Hodgkin's lymphoma treatment and has been used in the clinical treatment of various autoimmune diseases as well as in antirejection and immune induction therapy for kidney transplant recipients. Following RTX treatment, the time for B cell regeneration varies among patients, but there is no unified recommendation for the frequency of B cell monitoring. This study aimed to investigate the clinical significance of periodic monitoring of peripheral blood B lymphocytes in individualized immunotherapy following rituximab (RTX) treatment in patients with different diseases. This study included 488 patients with different diseases divided in four groups who were hospitalized and followed up from April 2017 to March 2024 (including 77, 161, 120, and 130 cases of neuromyelitis optica, pemphigus, membranous nephropathy, and kidney transplant recipients, respectively). Dynamic changes in percentage and absolute count of peripheral blood B lymphocytes before and after RTX treatment were investigated in the four groups, as well as the number of B cell subsets in 32 patients with optic neuromyelitis after RTX treatment. Although most patients showed high expression of B cells after 24 weeks, less than 6.8% of patients still began to experience B cell regeneration within 4 weeks. Thus, regular B cell monitoring following RTX treatment is helpful to better track the remission and recurrence of the disease and provide effective laboratory support for the selection and implementation of individualized immunotherapy.
利妥昔单抗（RTX）最初用于治疗非霍奇金淋巴瘤，现已用于多种自身免疫性疾病的临床治疗，以及肾移植受者的抗排斥和免疫诱导治疗。接受RTX治疗后，不同患者的B细胞再生时间各不相同，但对于B细胞监测的频率尚无统一建议。本研究旨在探讨在接受利妥昔单抗（RTX）治疗的不同疾病患者的个体化免疫治疗中，定期监测外周血B淋巴细胞的临床意义。本研究纳入了488例不同疾病患者，分为四组，于2017年4月至2024年3月住院并进行随访（分别包括77例、161例、120例和130例视神经脊髓炎、天疱疮、膜性肾病和肾移植受者）。研究了四组患者在RTX治疗前后外周血B淋巴细胞百分比和绝对计数的动态变化，以及32例视神经脊髓炎患者在RTX治疗后的B细胞亚群数量。尽管大多数患者在24周后显示B细胞高表达，但仍有不到6.8%的患者在4周内开始出现B细胞再生。因此，RTX治疗后定期进行B细胞监测有助于更好地追踪疾病的缓解和复发情况，并为个体化免疫治疗的选择和实施提供有效的实验室支持。
