Secondary antibody deficiency: a complication of anti-CD20 therapy for neuroinflammation

被引：67

作者：

Tallantyre, E. C. ^{[1
,2
]}

Whittam, D. H. ^{[3
,4
]}

Jolles, S. ^{[1
,2
]}

Paling, D. ^{[5
,6
]}

Constantinesecu, C. ^{[7
]}

Robertson, N. P. ^{[1
,2
]}

Jacob, A. ^{[3
,4
]}

机构：

[1] Univ Hosp Wales, Cardiff, S Glam, Wales

[2] Cardiff Univ, Sch Med, Cardiff, S Glam, Wales

[3] Walton Ctr NHS Trust, Liverpool L9 7LJ, Merseyside, England

[4] Univ Liverpool, Liverpool, Merseyside, England

[5] NIHR Sheffield Biomed Res Ctr Translat Neurosci, Sheffield, S Yorkshire, England

[6] Royal Hallamshire Hosp, Sheffield, S Yorkshire, England

[7] Univ Nottingham, Nottingham, England

来源：

JOURNAL OF NEUROLOGY | 2018年 / 265卷 / 05期

基金：

英国医学研究理事会;

关键词：

Anti-CD20; Rituximab; Secondary antibody deficiency; Infection; Complication; B-CELL DEPLETION; RELAPSING MULTIPLE-SCLEROSIS; LIVED PLASMA-CELLS; NEUROMYELITIS-OPTICA; RITUXIMAB; SAFETY; OCRELIZUMAB; EFFICACY; PREDICTORS; DISEASE;

D O I：

10.1007/s00415-018-8812-0

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

B-cell depleting anti-CD20 monoclonal antibody therapies are being increasingly used as long-term maintenance therapy for neuroinflammatory disease compared to many non-neurological diseases where they are used as remission-inducing agents. While hypogammaglobulinaemia is known to occur in over half of patients treated with medium to long-term B-cell-depleting therapy (in our cohort IgG 38, IgM 56 and IgA 18%), the risk of infections it poses seems to be under-recognised. Here, we report five cases of serious infections associated with hypogammaglobulinaemia occurring in patients receiving rituximab for neuromyelitis optica spectrum disorders. Sixty-four per cent of the whole cohort of patients studied had hypogammaglobulinemia. We discuss the implications of these cases to the wider use of anti-CD20 therapy in neuroinflammatory disease.

引用

页码：1115 / 1122

页数：8