International journal of hematology · 2020
Persistent hypogammaglobulinemia due to immunoglobulin class switch impairment by peri-transplant rituximab therapy.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Mizuhara Kentaro, Fujii Nobuharu, Meguri Yusuke, Takahashi Takahide, Aoe Michinori, Nakamura Makoto, Seike Keisuke, Sando Yasuhisa, Fujii Keiko, Abe Masaya, Sumii Yuichi, Urata Tomohiro, Fujiwara Yuki, Saeki Kyosuke, Asada Noboru, Ennishi Daisuke, Nishimori Hisakazu, Matsuoka Ken-Ichi, Maeda Yoshinobu
Аннотация
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.