Rituximab
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Late-onset neutropenia: 11 case reports A retrospective study identified eleven patients with rheumatic diseases who developed late-onset neutropenia following rituximab therapy [dosage and route not stated]. Three men and eight women, aged between 29-82 years, received at least one course of rituximab concurrently with a DMARD. Therapeutic indications included rheumatoid arthritis (5 patients), granulomatosis with polyangiitis (Wegener’s; 3 patients) and systemic lupus erythematosus (3 patients). Late-onset neutropenia occurred between 40-362 days from the last rituximab treatment (median 102 days), and lasted from 4-20 days (median 9 days). Seven patients developed infections. Six patients with sepsis and one with febrile neutropenia required hospitalisation and IV antibiotic therapy. Granulocyte colony-stimulating factor (G-CSF) was given to 6 patients. Absolute neutrophil counts recovered in all patients; 3 patients who had not received G-CSF took the longest to recover. Five patients experienced clinical relapse and were retreated with rituximab. Late-onset neutropenia recurred in 1 patient. Two patients showed no late-onset neutropenia, but the diagnosis might have been missed. In two other patients, late-onset neutropenia recurred after the second course of rituximab. Tesfa D, et al. Late-onset neutropenia following rituximab therapy in rheumatic diseases: Association with B lymphocyte depletion and infections. Arthritis and Rheumatism 63: 2209-2214, No. 8, Aug 2011. Available from: URL: http:// 803060551 dx.doi.org/10.1002/art.30427 - Sweden
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Reactions 24 Sep 2011 No. 1370
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