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Blood, 15 September 2002, Vol. 100, No. 6, pp. 2257-2259
BRIEF REPORT
Rituximab treatment results in impaired secondary humoral immune
responsiveness
Lizet E. van der Kolk,
Joke
W. Baars,
Martin H. Prins, and
Marinus H. J. van
Oers
From the Department of Hematology and the Department of
Clinical Epidemiology and Biostatistics, Academic Medical Center,
Amsterdam, and the Department of Medical Oncology, Antoni van
Leeuwenhoek Hospital/Netherlands Cancer Institute, Amsterdam, The
Netherlands.
In lymphoma patients, treatment with chimeric CD20 monoclonal
antibodies (rituximab) results in a depletion of normal and malignant B
cells, persisting for 6 to 9 months. This B-cell depletion leads
neither to a decrease in immunoglobulin levels nor an increase in the
number of infectious complications. However, the effect of rituximab
treatment on the immune responsiveness is unknown. In 11 patients with
relapsed, low-grade lymphoma, we investigated the effect of rituximab
treatment on the humoral immune response to 2 primary antigens and 2 recall antigens. After rituximab treatment, the humoral immune response
to the recall antigens was significantly decreased when compared with
the response before treatment. Already before rituximab treatment, none
of these patients was able to mount a response to the primary antigens.
These findings are relevant regarding the feasibility of rituximab in
maintenance treatment and may also offer a rationale for the treatment
of antibody-mediated autoimmune diseases with rituximab.
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