Rituximab and Immune Deficiency: Case Series and Review of the Literature

Kaplan, Blanka; Kopyltsova, Yelena; Khokhar, Amrita; Lam, Fung; Bonagura, Vincent R.

doi:10.1016/j.jaip.2014.06.003

Cited by 97 publications

(78 citation statements)

References 27 publications

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“…Given that hgg worsens with disease duration, clinical (infection history) and laboratory (Ig level) evaluations should be performed at least every 6-12 months, although the timing should be tailored to each patient. Because treatment for cll can itself worsen hgg and lead to infections, it is also advisable to measure serum Ig levels and circulating CD19+ B cells before treatment with immunomodulatory agents is started 28 . For some agents (rituximab, for instance), delayed B-cell recovery (>9 months) and treatment-induced neutropenia could be associated with an increased risk of serious infections 28,29 .…”

Section: Assessing the Risk Of Infectionmentioning

confidence: 99%

“…Because treatment for cll can itself worsen hgg and lead to infections, it is also advisable to measure serum Ig levels and circulating CD19+ B cells before treatment with immunomodulatory agents is started 28 . For some agents (rituximab, for instance), delayed B-cell recovery (>9 months) and treatment-induced neutropenia could be associated with an increased risk of serious infections 28,29 . Thus, periodic measurement of Ig levels and CD19+ B cells could aid in identifying patients at risk.…”

Section: Assessing the Risk Of Infectionmentioning

confidence: 99%

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A Canadian Perspective on the Use of Immunoglobulin Therapy to Reduce Infectious Complications in Chronic Lymphocytic Leukemia

Lachance

Christofides²,

Lee³

et al. 2016

Current Oncology

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Infections are a major cause of morbidity and mortality in patients with chronic lymphocytic leukemia (cll), who typically have increased susceptibility because of hypogammaglobulinemia (hgg) related to their disease and its treatment. Immunoglobulin replacement therapy (igrt) has been shown to reduce the frequency of bacterial infections and associated hospitalizations in patients with hgg or a history of infection, or both. However, use of igrt in cll is contentious. Studies examining such treatment were conducted largely before the use of newer chemoimmunotherapies, which can extend lifespan, but do not correct the hgg inherent to the disease. Thus, the utility of igrt has to be re-evaluated in the current setting. Here, we discuss the evidence for the use of igrt in cll and provide a practical approach to its use in the prevention and management of infections.

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Section: Assessing the Risk Of Infectionmentioning

confidence: 99%

Section: Assessing the Risk Of Infectionmentioning

confidence: 99%

A Canadian Perspective on the Use of Immunoglobulin Therapy to Reduce Infectious Complications in Chronic Lymphocytic Leukemia

Lachance

Christofides²,

Lee³

et al. 2016

Current Oncology

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“…Por ello, la IgIV de reemplazo está indicada cuando existe hipogammaglobulinemia e infecciones recurrentes. (GRADE C2) 90,91,92,93,94,95,96,97,98,99 Infección pediátrica por VIH R Se recomienda IgIV a dosis de reemplazo para prevenir infecciones bacterianas graves en pacientes con hipogammaglobulinemia (IgG < 400 mg/dL) e infección por el virus de la inmunodeficiencia humana. No se ha documentado que reduzca la estancia intrahospitalaria ni la mortalidad en pacientes con infecciones bacterianas.…”

Section: Leucemia Linfocítica Crónicaunclassified

Guía colombiana de práctica clínica para el uso de inmonuglobulinas en el tratamiento de reemplazo e inmunomodulación

Olivares

Olmos²,

Álvarez

et al. 2017

RAM

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Immunoglobulins are heterodimeric proteins composed of 2 heavy chains and 2 light chains. Human immunoglobulin G (IgG) is a plasma derivative and contains more than 95% of IgG. The composition of IgG subclasses is similar to that of normal human plasma. Immunoglobulin therapy was first introduced more than 50 years ago, and its use has been described in numerous diseases. In Colombia, the importance of this immunomodulatory resource prompted the need for clinical practice guidelines to be available for its use. For this reason, a multidisciplinary group of experts was brought together and distributed in working groups, by specialties, in order to develop an initial manuscript. Systematic literature searches were undertaken; identified evidences were evaluated and classified to support a preliminary draft that was discussed, analyzed and amended. Recommendations were issued on the use of intravenous immunoglobulin in pathologies that include primary and secondary immunodeficiencies, autoimmune diseases, neurological disorders, infections, transplants and miscellaneous conditions; grades were assigned to each one of them according to the GRADE system. The final result translated into recommendations that are put forth with the purpose to inform, guide and support on optimal use of this immunomodulatory resource.

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“…1,7 The reported incidence of PML in rituximab-exposed patients is 1 in 25,000 vs 1 in 1,000 for natalizumab-exposed patients.…”

Section: Practical Implicationsmentioning

confidence: 99%

“…7 These patients were thought predisposed to long-term dysfunction of B cells. 7 Furthermore, PML risk increases with prolonged treatment duration with natalizumab, prior immunosuppressive medications, and seropositivity to the JC virus.…”

Section: Practical Implicationsmentioning

confidence: 99%

PML in a patient with myasthenia gravis treated with multiple immunosuppressing agents

2016

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Rituximab and Immune Deficiency: Case Series and Review of the Literature

Cited by 97 publications

References 27 publications

A Canadian Perspective on the Use of Immunoglobulin Therapy to Reduce Infectious Complications in Chronic Lymphocytic Leukemia

A Canadian Perspective on the Use of Immunoglobulin Therapy to Reduce Infectious Complications in Chronic Lymphocytic Leukemia

Guía colombiana de práctica clínica para el uso de inmonuglobulinas en el tratamiento de reemplazo e inmunomodulación

PML in a patient with myasthenia gravis treated with multiple immunosuppressing agents

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