利妥昔单抗对B细胞非霍奇金淋巴瘤患者体液免疫的影响*

Effect of Rituximab on humoral immunity in patients with B-cell non-Hodgkin’s lymphoma*

摘要:

Abstract:

Objective To investigate the effect of Rituximab (RTX) on humoral immunity of patients with B cell Non-Hodgkin lymphoma (B-NHL). Methods Eighty-six B-NHL patients who were diagnosed with B-NHL in The Second Affiliated Hospital of Anhui Medical University were analyzed retrospectively. Patients were divided into observation group and control group. Patients in the observation group received RTX combined with cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) regimen, and patients in the control group received CHOP treatment. CD20+B lymphocytes, serum immunoglobulin as well as major subtypes were compared before and after treatment, and the incidence of infection was recorded. Results After 4 courses of treatment, CD20+ B lymphocytes occurred in peripheral blood of 14% (9/64) patients in the observation group, while the number was 100% (16/16) in control group. The levels of serum immunoglobulin, IgG, IgA and IgM in the observation group decreased significantly after chemotherapy, while no significant difference in Ig, IgG, IgA or IgM were witnessed before and after treatment in the control group. Incidence of hypo-immunoglobulinemia was significantly increased in the observation group after 4 courses of treatment compared with control group. Infection rate in the observation group was 45.71% and 81.25% of which were grade1-to 2 events. Incidence of infection in patients with low immunoglobulin increased significantly compared with those with normal immunoglobulin. Conclusions RTX treating B-NHL destroys the humoral immunity and increases the incidence of infection. Dynamical measurement of serum immunoglobulin and its major subtypes is necessary for prevention of infectious complications when receiving RTX.