Immune reconstitution following rituximab-based immunochemotherapy in pediatric patients with B-cell non-Hodgkin lymphomas

Semchenkova, Alexandra; Zhogov, Vladimir; Руднева, А. Е.; Potapenko, L.A.; Plyasunova, S. A.; Miakova, Natalia; Самочатова, Е. В.; Maschan, Alexey; Popov, Alexander

doi:10.1080/10428194.2021.1998486

Cited by 4 publications

(6 citation statements)

References 15 publications

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“…In adults, multiple RTX dose schemas led to prolonged 12-18-month immunorestitution 14,61,68,70,71 . Semsenchova et al observed the first B cell reconstitution in pediatric B-NHL patients four month after RTX administration 12,66,67 In the line with published observations, the B cell subset proportion in our cohort dynamically changed over the FU period reflecting the B cell subset development pattern in infancy 21 .…”

Section: B Cell Compartment Reconstitutionsupporting

confidence: 89%

“…Furthermore, patients with malignant diseases treated with RTX appear to be more prone to clinical manifestation of immunodeficiency than RTXtreated patients with autoimmune diseases 14,65 . Also, younger age appears to favor post-RTX B lymphocyte reconstitution 12,[66][67][68] .…”

Section: Discussionmentioning

confidence: 99%

“…However, the introduction of RTX into the B-NHL treatment protocols is followed by the risk of develop-ment of secondary antibody deficiency and infections 3,[9][10][11] . It also remains true that the pediatric data on long-term B cell reconstitution and antibody production after RTX in treatment protocols in B-NHL patients are inconsistent 3,12 . RTX, a chimeric, genetically engineered, murine/human monoclonal antibody (mAb) directed against the membrane-embedded cluster of differentiation (CD) 20 antigen, is a B cell-targeted therapy (BCTT) (ref.…”

Section: Introductionmentioning

confidence: 99%

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B cell subsets reconstitution and immunoglobulin levels in children and adolescents with B non-Hodgkin lymphoma after treatment with single anti CD20 agent dose included in chemotherapeutic protocols: single center experience and review of the literature

Hlaváčková¹,

Křenová²,

Kerekes³

et al. 2024

BIOMED PAP

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Background. RTX, an anti-CD20 monoclonal antibody, added to chemotherapy has proven to be effective in children and adolescents with high-grade, high-risk and matured non-Hodgkin lymphoma. RTX leads to prompt CD19+ B lymphocyte depletion. However, despite preserved immunoglobulin production by long-lived plasmablasts after treatment, patients remain at risk of prolonged hypogammaglobulinemia. Further, there are few general guidelines for immunology laboratories and clinical feature monitoring after B cell-targeted therapies. The aim of this paper is to describe B cell reconstitution and immunoglobulin levels after pediatric B-NHL protocols, that included a single RTX dose and to review the literature. Methods. A retrospective single-center study on the impact of a single RTX dose included in a chemotherapeutic pediatric B Non-Hodgkin Lymphoma (B-NHL) treatment protocols. Immunology laboratory and clinical features were evaluated over an eight hundred days follow-up (FU) period, after completing B-NHL treatment. Results. Nineteen patients (fifteen Burkitt lymphoma, three Diffuse large B cell lymphoma, and one Marginal zone B cell lymphoma) fulfilled the inclusion criteria. Initiation of B cell subset reconstitution occurred a median of three months after B-NHL treatment. Naïve and transitional B cells declined over the FU in contrast to the marginal zone and the switched memory B cell increase. The percentage of patients with IgG, IgA, and IgM hypogammaglobulinemia declined consistently over the FU. Prolonged IgG hypogammaglobulinemia was detectable in 9%, IgM in 13%, and IgA in 25%. All revaccinated patients responded to protein-based vaccines by specific IgG antibody production increase. Following antibiotic prophylaxes, none of the patients with hypogammaglobulinemia manifested with either a severe or opportunistic infection course. Conclusion. The addition of a single RTX dose to the chemotherapeutic treatment protocols was not shown to increase the risk of developing secondary antibody deficiency in B-NHL pediatric patients. Observed prolonged hypogammaglobulinemia remained clinically silent. However interdisciplinary agreement on regular long-term immunology FU after anti-CD20 agent treatment is required.

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Section: B Cell Compartment Reconstitutionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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B cell subsets reconstitution and immunoglobulin levels in children and adolescents with B non-Hodgkin lymphoma after treatment with single anti CD20 agent dose included in chemotherapeutic protocols: single center experience and review of the literature

Hlaváčková¹,

Křenová²,

Kerekes³

et al. 2024

BIOMED PAP

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“…Furthermore, studies about immunologic reconstitution after RTX post-HCT are scant in the pediatric population. 10 In our study, we analyzed the main lymphocyte subsets in a pediatric population undergoing HCT for nonmalignant disorders, receiving RTX for EBV reactivation. The aim was to identify the differences in immunologic reconstitution between 2 groups of patients, those who are developing hypogammaglobulinemia post-RTX and those who do not, to identify a marker associated with persistent hypogammaglobulinemia during the process of adaptative cell recovery.…”

mentioning

confidence: 99%

“…No marker associated with the development of persistent hypogammaglobulinemia in patients undergoing HCT and receiving RTX has been identified so far. Furthermore, studies about immunologic reconstitution after RTX post-HCT are scant in the pediatric population 10. In our study, we analyzed the main lymphocyte subsets in a pediatric population undergoing HCT for nonmalignant disorders, receiving RTX for EBV reactivation.…”

mentioning

confidence: 99%

Hypogammaglobulinemia in Children After Hematopoietic Stem Cell Transplantation and Rituximab Treatment: Relevance of B Cell Subsets

Antonio

Serena

Mainardi³

et al. 2022

Journal of Pediatric Hematology/Oncology

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Rituximab (RTX) is widely employed to treat Epstein-Barr virus reactivation in children undergoing Hematopoietic Cell Transplantation (HCT). The resulting loss of B cells may cause persistent hypogammaglobulinemia. This retrospective cross-sectional study aims to identify flow cytometry biomarkers associated with persistent hypogammaglobulinemia in patients receiving RTX after HCT. We analyzed 5 patients (cases group) requiring immunoglobulin substitution due to low level of IgG (IgG <5 g/L) detected after RTX treatment and 5 patients (controls group) not requiring long-term immunoglobulin (Ig) substitution. We investigated the B cell reconstitution, and in patients group we observed a significantly lower count in B total, IgD+CD27+ marginal B cells and IgD-CD27+ switched-memory B cells, after a median of 5 years from HCT, compared with the control group. Despite the importance limits of our study and the heterogeneity of our data (age of included patients, time of evaluation, interval between RTX dose and assessment) we conclude that RTX given early after HCT might cause a deranged B cell maturation, contributing to the delation in B cell recovery following HCT, and switched memory and marginal zone B cell counts could be a promising biomarker to identify patients requiring long-term Ig substitution.

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OMIP‐108: 22‐color flow cytometry panel for detection and monitoring of chimerism and immune reconstitution in porcine‐to‐baboon models of operational xenotransplant tolerance studies

Gunes,

Wolbrom,

Nygaard

et al. 2024

Cytometry Pt A

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Immune reconstitution following rituximab-based immunochemotherapy in pediatric patients with B-cell non-Hodgkin lymphomas

Cited by 4 publications

References 15 publications

B cell subsets reconstitution and immunoglobulin levels in children and adolescents with B non-Hodgkin lymphoma after treatment with single anti CD20 agent dose included in chemotherapeutic protocols: single center experience and review of the literature

B cell subsets reconstitution and immunoglobulin levels in children and adolescents with B non-Hodgkin lymphoma after treatment with single anti CD20 agent dose included in chemotherapeutic protocols: single center experience and review of the literature

Hypogammaglobulinemia in Children After Hematopoietic Stem Cell Transplantation and Rituximab Treatment: Relevance of B Cell Subsets

OMIP‐108: 22‐color flow cytometry panel for detection and monitoring of chimerism and immune reconstitution in porcine‐to‐baboon models of operational xenotransplant tolerance studies

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