Single-cycle rituximab-induced immunologic changes in children: Enhanced in neuroimmunologic disease?


Journal

Neurology(R) neuroimmunology & neuroinflammation
ISSN: 2332-7812
Titre abrégé: Neurol Neuroimmunol Neuroinflamm
Pays: United States
ID NLM: 101636388

Informations de publication

Date de publication:
07 2020
Historique:
received: 20 12 2019
accepted: 17 03 2020
entrez: 8 5 2020
pubmed: 8 5 2020
medline: 14 9 2021
Statut: epublish

Résumé

To investigate the immunologic impact of a single cycle of rituximab (RTX) in children and adolescents with immune-mediated disorders, we evaluated B cells and immunoglobulin levels of 20 patients with neuroimmunologic, nephrologic, dermatologic, and rheumatologic disorders treated under recommended guidelines. Retrospective study of immunologic changes in children (aged ≤18 years) diagnosed with immune-mediated disorders in which RTX was prescribed between June 2014 and February 2019. Patients were excluded if they had prior diagnosis of malignant disease or primary immunodeficiency. Patients were clinically and immunologically followed up every 3 months. Only patients having received a single cycle of RTX and with a follow-up greater than 12 months were included in the analysis of persistent dysgammaglobulinemia. Twenty children were included. Median age at RTX treatment was 12.8 years (interquartile range [IQR] 6.6-15.5 years). Median follow-up was 12.6 months (IQR 10.2-24 months). Of the 14 patients eligible for persistent dysgammaglobulinemia analysis (3 had received RTX retreatment, 2 had <12 months post-RTX follow-up, and in 1 data for this time point was missing), 2/14 (14%) remained with complete B-cell depletion, and 5/14 (36%) had dysgammaglobulinemia. Patients with dysgammaglobulinemia were younger (7.8 vs 15.6 years, In our cohort, single-cycle RTX-induced dysgammaglobulinemia was enhanced in patients with neuroimmunologic diseases. Further studies are needed to confirm this observation.

Identifiants

pubmed: 32376706
pii: 7/4/e724
doi: 10.1212/NXI.0000000000000724
pmc: PMC7217658
pii:
doi:

Substances chimiques

Immunologic Factors 0
Rituximab 4F4X42SYQ6

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

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Auteurs

Angela Deyà-Martínez (A)

From the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.

Yadira Gordón (Y)

From the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.

Cristina Molina-Anguita (C)

From the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.

Alexandru Vlagea (A)

From the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.

Monica Piquer (M)

From the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.

Manel Juan (M)

From the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.

Ana Esteve-Solé (A)

From the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.

Jordi Antón (J)

From the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.

Álvaro Madrid (Á)

From the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.

Ana García-García (A)

From the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.

Ana M Plaza (AM)

From the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.

Thaís Armangue (T)

From the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain. lalsina@sjdhospitalbarcelona.org armangue@clinic.cat.

Laia Alsina (L)

From the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain. lalsina@sjdhospitalbarcelona.org armangue@clinic.cat.

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