Incidence of Profound Hypogammaglobulinemia and Infection Rate in Lymphoma Patients Following the Combination of Chemotherapy and Rituximab

Author(s): Kalman Filanovsky, Edward B. Miller, Erica Sigler, Alain Berrebi, Lev Shvidel.

Journal Name: Recent Patents on Anti-Cancer Drug Discovery

Volume 11 , Issue 2 , 2016

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Abstract:

Background: The Anti-CD20 monoclonal antibody Rituximab suppresses B-lymphocytes and may induce hypogammaglobulinemia in treated patients. The incidence and clinical significance of rituximab induced hypogammaglobulinemia in lymphoma patients is underestimated.

Methods: We retrospectively analyzed the rates of hypogammaglobulinemia, infection and infectionrelated mortality in 136 lymphoma patients who were treated with a combination of chemotherapy and rituximab.

Results: Rituximab given in more than 8 doses (OR 6.05, 95% CI: 1.24-29.5), relative hypogammaglobulinemia at time of lymphoma diagnosis (OR 4.2, 95% CI: 1.26-14.1) and the combination of fludarabine with rituximab (OR 3.4, 95% CI: 1.24-9.47) were factors significantly associated with prolonged (more than 6 months) hypogammaglobulinemia. The combination of fludarabine and rituximab (OR 6.4, 95% CI: 1.49-27.0) and secondarily prolonged hypogammaglobulinemia (OR 4.5, 95% CI: 1.19-18.5) were found to be predictive factors for severe infections and infection-related mortality.

Conclusion: These data suggest the importance of following serum immunoglobulin levels before and after combination immuno-chemotherapy, particularly in patients with recurrent infections or relapsed/refractory disease.

Keywords: Hypogammaglobulinemia, immunochemotherapy, infection-related mortality, non-hodgkin lymphoma, nonneutropenic infection, rituximab.

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Article Details

VOLUME: 11
ISSUE: 2
Year: 2016
Page: [228 - 235]
Pages: 8
DOI: 10.2174/1574892811666160129110614
Price: $58

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