Immunreconstitution and Infectious Complications After Rituximab Treatment in Children and Adolescents: What Do We Know and What Can We Learn from Adults?

Cancers

Jennifer Worch²  Olga Makarova²  Birgit Burkhardt¹  Georg Lenz² 

[1] Pediatric Hematology and Oncology, University Children’s Hospital Münster, Münster, 48149, Germany;

关键词: rituximab;    immunreconstitution;    infections;    children;    adolescents;   

DOI  :  10.3390/cancers7010305

来源: mdpi

【 摘 要 】

Rituximab, an anti CD20 monoclonal antibody, is widely used in the treatment of B-cell malignancies in adults and increasingly in pediatric patients. By depleting B-cells, rituximab interferes with humoral immunity. This review provides a comprehensive overview of immune reconstitution and infectious complications after rituximab treatment in children and adolescents. Immune reconstitution starts usually after six months with recovery to normal between nine to twelve months. Extended rituximab treatment results in a prolonged recovery of B-cells without an increase of clinically relevant infections. The kinetic of B-cell recovery is influenced by the concomitant chemotherapy and the underlying disease. Intensive B-NHL treatment such as high-dose chemotherapy followed by rituximab bears a risk for prolonged hypogammaglobulinemia. Overall transient alteration of immune reconstitution and infections after rituximab treatment are acceptable for children and adolescent without significant differences compared to adults. However, age related disparities in the kinetic of immune reconstitution and the definitive role of rituximab in the treatment for children and adolescents with B-cell malignancies need to be evaluated in prospective controlled clinical trials.

【 授权许可】

CC BY   
© 2015 by the authors; licensee MDPI, Basel, Switzerland.