Abstract
Background Bone marrow infiltration of lymphoma cells is a candidate risk factor for infusion-related reactions (IRRs) in patients with CD20-positive B-cell non-Hodgkin lymphoma (B-NHL). However, despite with the lack of sufficient data, the effect of bone marrow infiltration of B-NHL cells on the incidence rate of grade 2 or higher IRRs with the administration of rituximab has been retrospectively studied in this paper. Methods Patients with CD20-positive B-NHL who received the rituximab induction therapy for the first time were enrolled in this study. To evaluate the bone marrow infiltration of B-NHL cells, May–Giemsa stain of bone marrow films and flow cytometry examination of bone marrow aspiration samples were performed. IRR grade was determined using the IRR criteria in the Common Terminology Criteria for Adverse Events version 4.0. Results A total of 127 patients were eligible for this study. Grade 2 or higher IRRs were observed in 43 (34%) patients. In univariate analysis, use of glucocorticoid before rituximab infusion was a strong risk-avoiding factor for grade 2 or higher IRRs. Advanced stage of disease (Ann Arbor: stages III and IV) or bone marrow infiltration of B-NHL cells revealed the risk factors, regardless of glucocorticoid premedication. Using multivariate analysis, bone marrow infiltration was found to be an independent risk factor for patients without prior glucocorticoid use. Conclusion Bone marrow infiltration of B-NHL cells is a risk factor for grade 2 or higher IRRs at the first rituximab induction therapy without glucocorticoid premedication.
Highlights
Rituximab is used as a chimeric anti-CD20 monoclonal antibody drug for the human CD20 antigen expressed on the surface of B lymphoma cells or normal B lymphocytes.Rituximab is useful for treating CD20-positive B-cell nonHodgkin lymphoma (B-NHL) or CD20-positive lymphoproliferative disorders under immunosuppressive treatment [1]
25 patients were excluded from the study as they did not fulfil the inclusion criteria, i.e., the second or after time of rituximab infusion therapy (17 patients), no bone marrow aspiration or biopsy test or insufficient results (6 patients), and insufficient laboratory data (2 patients)
A retrospective study was conducted to determine whether bone marrow infiltration is a risk factor under the first induction rituximab therapy in CD20-positive B-cell non-Hodgkin lymphoma (B-NHL)
Summary
Rituximab is used as a chimeric anti-CD20 monoclonal antibody drug for the human CD20 antigen expressed on the surface of B lymphoma cells or normal B lymphocytes.Rituximab is useful for treating CD20-positive B-cell nonHodgkin lymphoma (B-NHL) or CD20-positive lymphoproliferative disorders under immunosuppressive treatment [1]. In clinical practice, developing IRRs during the second or after the third infusion of rituximab is not frequently recognized, and the reason for reducing the IRR risk comes from the decreased cytokine reaction in accordance with the reduction of CD20-positive B-NHL cells. Bone marrow infiltration of lymphoma cells is a candidate risk factor for infusion-related reactions (IRRs) in patients with CD20-positive B-cell non-Hodgkin lymphoma (B-NHL). Despite with the lack of sufficient data, the effect of bone marrow infiltration of B-NHL cells on the incidence rate of grade 2 or higher IRRs with the administration of rituximab has been retrospectively studied in this paper. Use of glucocorticoid before rituximab infusion was a strong risk-avoiding factor for grade 2 or higher IRRs. Advanced stage of disease (Ann Arbor: stages III and IV) or bone marrow infiltration of B-NHL cells revealed the risk factors, regardless of glucocorticoid premedication
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