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

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

Volume: 11 Issue: 2

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

Affiliation:

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

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.

Cite this article as:

Filanovsky Kalman, B. Miller Edward, Sigler Erica, Berrebi Alain and Shvidel Lev, Incidence of Profound Hypogammaglobulinemia and Infection Rate in Lymphoma Patients Following the Combination of Chemotherapy and Rituximab, Recent Patents on Anti-Cancer Drug Discovery 2016; 11 (2) . https://dx.doi.org/10.2174/1574892811666160129110614