Risk of secondary hypogammaglobulinaemia after Rituximab and Fludarabine in indolent non-Hodgkin lymphomas: A retrospective cohort study

Angelis, Federico De; Tosti, Maria Elena; Capria, Saveria; Russo, Eleonora; D’Elia, Gianna Maria; Annechini, Giorgia; Stefanizzi, Caterina; Foà, Robin; Pulsoni, Alessandro

doi:10.1016/j.leukres.2015.10.013

Cited by 33 publications

(31 citation statements)

References 29 publications

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“…on June 7, 2019. by guest www.bloodjournal.org From after BMT. The adoption of maintenance-type therapy (eg, immunotherapy for lymphoma, lenalidomide for multiple myeloma) increases the risk of new complications (eg, hypogammaglobulinemia after rituximab 77,78 ) that may develop after BMT. This high burden of morbidity necessitates that strategies be developed for early detection of these complications.…”

Section: Discussionmentioning

confidence: 99%

How I monitor long-term and late effects after blood or marrow transplantation

Bhatia

Armenian

Landier

2017

Blood

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Blood or marrow transplantation (BMT) is used with curative intent for hematologic malignancies. Conditional on surviving the first 2 years after BMT, 5-year survival generally exceeds 70%. However, the cumulative therapeutic exposures lead to premature onset of chronic health conditions, such that the 15-year cumulative incidence of severe or life-threatening chronic health conditions exceeds 40%, resulting in premature mortality. The high burden of morbidity, coupled with a long latency between BMT and the development of chronic health conditions necessitates life-long risk-based monitoring of the BMT survivors. The issues of how and when to screen BMT survivors for therapyrelated complications and exacerbation of preexisting conditions are important and largely unanswered questions. For BMT survivors, screening recommendations must incorporate risks associated with pre-BMT therapy as well as risks related to transplant conditioning and graft-versus-host disease. Here, we describe our approach to monitoring BMT survivors for risk-based screening and early detection of key late-occurring or long-term complications using patient scenarios to illustrate our discussion. (Blood. 2017;130(11):1302-1314

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Section: Discussionmentioning

confidence: 99%

How I monitor long-term and late effects after blood or marrow transplantation

Bhatia

Armenian

Landier

2017

Blood

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“…Rituximab had increased physician's armamentarium for the treatment of HM, although it is relatively clear that maintenance rituximab therapy alone or in combination with other drugs is a risk factor of infection and HG. 4,5,18 Our study provides data on MM and CLL, two well-known hematological malignancies, but also on indolent non-Hodgkin B-cell lymphoma.…”

Section: Hm-associated Sidmentioning

confidence: 99%

“…3 Treatment of NHL has been associated with HG. 4,5 Chemotherapies with alkylating agents or purine analogues, immunotherapy (anti-CD20 and anti-CD52 monoclonal antibodies), or the combination of both is associated with HG. 6 HM-associated SID exposes the patient to an increased risk of infections which are acknowledged as the main causes of morbidity and mortality in MM and CLL patients.…”

Section: Introductionmentioning

confidence: 99%

A French observational study describing the use of human polyvalent immunoglobulins in hematological malignancy‐associated secondary immunodeficiency

Benbrahim

Viallard

Choquet

et al. 2018

European J of Haematology

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Objective: To describe the characteristics of patients suffering from secondary immunodeficiencies (SID) associated with hematological malignancies (HM), who started immunoglobulin replacement therapy (IgRT), physicians' expectations regarding IgRT, and IgRT modalities.Methods: Non-interventional, prospective French cross-sectional study. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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“…Severe or unusual infections, with higher rates of global infections compared with the historical group of patients treated with FC alone but without significant influence in infection-related mortality have been reported (62). Particularly, the growing use of Rtx in front-line combination chemotherapy with fludarabine (FCR) increases the risk of all types of infections with respect to Rtx in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or with cyclophosphamide, vincristine, and prednisone (R-CVP) chemotherapy (68). FCR regimen results in a significant myelosuppression and high rates of early and late infections, especially in elderly patients (61).…”

Section: Diagnosis and Therapy Issues Challenging The Role Of Preventmentioning

confidence: 99%

Challenges in the Role of Gammaglobulin Replacement Therapy and Vaccination Strategies for Hematological Malignancy

2016

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Patients with chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) are prone to present with antibody production deficits associated with recurrent or severe bacterial infections that might benefit from human immunoglobulin (Ig) (IVIg/SCIg) replacement therapy. However, the original IVIg trial data were done before modern therapies were available, and the current indications do not take into account the shift in the immune situation of current treatment combinations and changes in the spectrum of infections. Besides, patients affected by other B cell malignancies present with similar immunodeficiency and manifestations while they are not covered by the current IVIg indications. A potential beneficial strategy could be to vaccinate patients at monoclonal B lymphocytosis and monoclonal gammopathy of undetermined significance stages (for CLL and MM, respectively) or at B-cell malignancy diagnosis, when better antibody responses are attained. We have to re-emphasize the need for assessing and monitoring specific antibody responses; these are warranted to select adequately those patients for whom early intervention with prophylactic anti-infective therapy and/or IVIg is preferred. This review provides an overview of the current scenario, with a focus on prevention of infection in patients with hematological malignancies and the role of Ig replacement therapy.

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Risk of secondary hypogammaglobulinaemia after Rituximab and Fludarabine in indolent non-Hodgkin lymphomas: A retrospective cohort study

Cited by 33 publications

References 29 publications

How I monitor long-term and late effects after blood or marrow transplantation

How I monitor long-term and late effects after blood or marrow transplantation

A French observational study describing the use of human polyvalent immunoglobulins in hematological malignancy‐associated secondary immunodeficiency

Challenges in the Role of Gammaglobulin Replacement Therapy and Vaccination Strategies for Hematological Malignancy

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