Hypogammaglobulinemia Following Rituximab and High-Dose Therapy and Autologous Stem-Cell Transplant: Incidence and Predictors of Prolonged Immunoglobulin Deficiencies

• Published in: Blood 2008-11, Vol.112 (11), p.4351-4351
• Main Authors: Pennell, Nancy, Cheung, Matthew, Hicks, Lisa K, Buckstein, Rena, Imrie, Kevin R, Piliotis, Eugenia, Spaner, David, Ghorab, Zeina, Reis, Marciano D., Milliken, Violet, Boudreau, Angela, Berinstein, Neil
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V112.11.4351.4351

High-dose therapy and autologous stem cell transplantation (HDT/ASCT) and rituximab immunotherapy have been increasingly applied in the management of non-Hodgkin's lymphomas (NHL). Although both approaches have been individually associated with B-cell depletion and hypogammaglobulinemia, the incidence, time course, and predictors of prolonged deficiencies following a combined treatment approach is unknown. Methods: We completed a series of prospective phase II studies of HDT/ASCT combined with rituximab for patients with relapsed follicular lymphoma (FL) or diffuse large B cell lymphoma (DLBCL). In two phase II trials of patients with FL (R/Tx and R-IFN/Tx), patients received 9 infusions of rituximab 375mg/m2 as both an in vivo purge and as maintenance post HDT/ASCT. In a trial with relapsed DLBCL or transformed lymphoma, patients received 8 infusions with rituximab 375mg/m2 only as part of the salvage chemotherapy regimen (R-ESHAP/Tx). Immunoglobulin levels were expressed as percentages with 100% representing the lower limit of normal at the institutional lab. Hypogammaglobulinemia was defined as