Persistent hypogammaglobulinemia due to immunoglobulin class switch impairment by peri-transplant rituximab therapy.
Int J Hematol
; 112(3): 422-426, 2020 Sep.
Article
em En
| MEDLINE
| ID: mdl-32342335
ABSTRACT
Post-transplant lymphoproliferative disorder (PTLD) is one of the most serious complications of allogeneic hematopoietic stem cell transplantation (HSCT). Rituximab is effective for PTLD; however, rituximab can produce adverse effects, including hypogammaglobulinemia. Here, we present the case of an 18-year-old female with refractory cytopenia of childhood who developed persistent selective hypogammaglobulinemia with low immunoglobulin G (IgG) 2 and IgG4 levels and monoclonal protein after rituximab therapy against probable PTLD. Despite B-cell recovery, the serum IgG levels gradually declined, reaching < 300 mg/dL at 33 months after rituximab treatment. In addition, class-switched memory (CD27 + IgD -) B cells were limited in phenotypic analysis. These findings suggest that peri-HSCT rituximab may contribute to an abnormal B-cell repertoire induced by impaired immunoglobulin class switch.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Imunoglobulina G
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Switching de Imunoglobulina
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Agamaglobulinemia
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Rituximab
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Transtornos Linfoproliferativos
Tipo de estudo:
Etiology_studies
Limite:
Adolescent
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Female
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Humans
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article