Rituximab-related viral infections in lymphoma patients

Abstract

Recently, a human/mouse chimeric monoclonal antibody, rituximab, has been successfully used to treat cases of B-cell non-Hodgkin's lymphoma and some autoimmune diseases. However, several viral infections related to rituximab have been reported in the literature, but were not well characterized. To further investigate this topic, relevant English language studies were identified through Medline. There were 64 previously reported cases of serious viral infection after rituximab treatment. The median age of the cases was 61 years (range: 21 - 79). The median time period from the start of rituximab treatment to viral infection diagnosis was 5.0 months (range: 1 - 20). The most frequently experienced viral infections were hepatitis B virus (HBV) (39.1%, n = 25), cytomegalovirus infection (CMV) (23.4%, n = 15), varicella-zoster virus (VZV) (9.4%, n = 6), and others (28.1%, n = 18). Of the patients with HBV infections, 13 (52.0%) died due to hepatic failure. Among the 39 cases that had viral infections other than HBV, 13 died due to these specific infections. In this study, about 50% of the rituximab-related HBV infections resulted in death, whereas this was the case in only 33% of the cases with other infections. Close monitoring for viral infection, particularly HBV and CMV, in patients treated with rituximab should be recommended.

Clinicopathologic and Demographic Evaluation of Triple-Negative Breast Cancer Patients among a Turkish Patient Population: a Single Center Experience

“…There was no significant difference between TN and NTN patients regarding mean age (52.3 vs 53.4). In a published, small cohort study in Turkey, mean age was reported as 44 among TN patients and 47.5 among NT patients; however, the difference was not significant (Aksoy et al, 2007). The mean age of patients with TN breast cancer is reported as 61 among American patients, and 50 among Hispanic women (SEER, 2010;LaraMedina et al, 2011).…”

Rituximab in the treatment of autoimmune haematological disorders

“…In addition, rituximab has a well-established safety profile through its use in haemato-oncological indications for over 10 years (Kimby, 2005). Physicians should be aware, however, that rituximab has been associated with rare cases of progressive multifocal encephalopathy, hepatitis B reactivation and other viral infections in NHL (Goldberg et al, 2002;Steurer et al, 2003;Aksoy et al, 2007;Freim Wahl et al, 2007;Kranick et al, 2007).…”

Les complications infectieuses liées à l’utilisation des anticorps monoclonaux chez l’homme

“…Cependant, dans tous ces cas d'infections virales, y compris pour l'infection à JC virus, le rituximab était prescrit en association avec d'autres molécules ou immunosuppresseurs, interdisant toute conclusion. Des réactivations virales dues au virus de l'hépatite B (HBV) ont également été rapportées sous rituximab [18][19][20][21] avec un risque de décès important [22]. Dans les quelques cas où le rituximab a entraîné une agammaglobulinémie, des infections bactériennes muqueuses ont été observées, requérant des traitements substitutifs par immunoglobulines polyvalentes [9,23].…”