Risk factors for infection in haematology patients treated with rituximab

Eur J Haematol. 2009 Jan;82(1):26-30. doi: 10.1111/j.1600-0609.2008.01165.x. Epub 2008 Nov 11.

Abstract

Objectives: Although rituximab therapy is not considered to be closely associated with infection, there have been reports of serious infections in patients treated with rituximab. We performed a statistical retrospective analysis to clarify the risk factors for infection in patients receiving rituximab therapy.

Methods: A retrospective study of data from clinical records was performed that targeted haematology patients treated at our university hospital between April 2003 and October 2006. We selected 63 patients with CD20-positive lymphoma whose peripheral blood immunoglobulin levels had been measured within 6 months before and after rituximab therapy. Logistic regression analysis was used to investigate the risk factors for serious infection in these patients.

Results: The three risk factors identified were: 1) reduction in IgM after administration of rituximab [odds ratio (OR) = 1.032, confidence interval (CI) = 1.007-1.057; P = 0.009], 2) duration of rituximab therapy [OR = 0.962, CI = 0.932-0.994; P = 0.021] and 3) G-CSF administration [OR = 4.825, CI = 1.411-16.495; P = 0.012].

Conclusions: Rituximab therapy may be associated with infection, indicating the need for sequential monitoring of IgM levels and identification of the optimal interval between rituximab cycles.

MeSH terms

  • Antibodies, Monoclonal / immunology*
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Murine-Derived
  • Female
  • Hematologic Diseases / drug therapy*
  • Hematologic Diseases / epidemiology
  • Hematologic Diseases / immunology*
  • Humans
  • Immunotherapy*
  • Infections / epidemiology
  • Infections / immunology*
  • Male
  • Middle Aged
  • Risk Factors
  • Rituximab

Substances

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