[Immunologic changes in diffuse large B-cell lymphomas after rituximab-CHOP treatment: own data and review of the literature]

Orv Hetil. 2012 Oct 21;153(42):1658-66. doi: 10.1556/OH.2012.29471.
[Article in Hungarian]

Abstract

Introduction: Rituximab treatment may induce a long-term B-cell depletion, which can be accompanied with an increased infection risk.

Aims: To examine the changes of the white blood cell, CD19+ B-cell and CD4+ T-cell counts and the levels of immunoglobulin G, A, M after rituximab containing chemotherapy and to explore the infectious complications in our patients and review of the literature.

Patients and methods: Thirty-five diffuse large B-cell lymphoma patients were examined, who were treated with rituximab-cyclophosphamide-vincristine-doxoribicine-prednisolone (R-CHOP). The B- and T-cell populations were analyzed with flow-cytometry while the immunoglobulin levels were measured by nephelometry.

Results: CD19+ B-lymphocytes were undetectable after the treatment and their count only increased from the post-therapeutic 12th month. Infection did not occur in this group of patients.

Conclusions: Rituximab induced B-cell depletion was appreciable also in this group of patients, while serious or unexpected infection did not occur. Increased infectious risk primarily can be observed after long-term, maintenance rituximab treatment.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal, Murine-Derived / administration & dosage
  • Antibodies, Monoclonal, Murine-Derived / adverse effects*
  • Antibodies, Monoclonal, Murine-Derived / immunology*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • B-Lymphocytes / drug effects
  • B-Lymphocytes / immunology
  • Cyclophosphamide / administration & dosage
  • Disease-Free Survival
  • Doxorubicin / administration & dosage
  • Female
  • Flow Cytometry
  • Hepatitis B / diagnosis
  • Humans
  • Immunoglobulins / blood
  • Incidence
  • Infections / diagnosis
  • Infections / etiology
  • Leukoencephalopathy, Progressive Multifocal / diagnosis
  • Leukoencephalopathy, Progressive Multifocal / etiology
  • Lymphocyte Count
  • Lymphoma, Large B-Cell, Diffuse / drug therapy*
  • Lymphoma, Large B-Cell, Diffuse / immunology*
  • Male
  • Middle Aged
  • Nephelometry and Turbidimetry
  • Neutropenia / chemically induced
  • Neutropenia / complications
  • Prednisone / administration & dosage
  • Recurrence
  • Retrospective Studies
  • Risk Assessment
  • Rituximab
  • T-Lymphocytes / drug effects
  • T-Lymphocytes / immunology
  • Time Factors
  • Treatment Outcome
  • Vincristine / administration & dosage

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Immunoglobulins
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone

Supplementary concepts

  • CHOP protocol