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01-02-2018 | Original Article

Delayed recovery of serum immunoglobulin G is a poor prognostic marker in patients with follicular lymphoma treated with rituximab maintenance

Authors: Yoshiharu Kusano, Masahiro Yokoyama, Norihito Inoue, Hirofumi Yamauchi, Anna Takahashi, Naoko Tsuyama, Yuko Mishima, Noriko Nishimura, Kengo Takeuchi, Yasuhito Terui, Kiyohiko Hatake

Published in: Annals of Hematology | Issue 2/2018

Abstract

Clinical trials involving various treatment schedules for rituximab maintenance have been conducted for patients with follicular lymphoma (FL) and have not confirmed their impact on serum immunoglobulin (sIg) levels until the completion of maintenance. However, the long-term use of rituximab is a concern because of circulating plasma cell-depletion risk, suggesting that the mechanism of change in sIg levels after RM has not been determined. Additionally, the relationship between host humoral immunity and the prognosis of patients with B cell malignancies has not been determined. We retrospectively investigated data from 213 patients with FL from a single institute who achieved at least a partial response with rituximab, cyclophosphamide, vincristine, and prednisolone with or without doxorubicin. Of these, 166 patients underwent RM with a median period of 1.6 years. A significantly delayed recovery of sIgG levels was observed in the maintenance group until 3 years after RM in comparison to the observation group. A multivariate analysis showed that a sIgG level of < 718 mg/dl 1 year after RM was an independent predictor for poor progression-free survival (PFS) (hazard ratio, 2.3; P = 0.04). Therefore, the sIgG levels scarcely recovered and were significantly delayed after RM, leading to shorter PFS in patients with FL.

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Title: Delayed recovery of serum immunoglobulin G is a poor prognostic marker in patients with follicular lymphoma treated with rituximab maintenance
Authors: Yoshiharu Kusano
Masahiro Yokoyama
Norihito Inoue
Hirofumi Yamauchi
Anna Takahashi
Naoko Tsuyama
Yuko Mishima
Noriko Nishimura
Kengo Takeuchi
Yasuhito Terui
Kiyohiko Hatake
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: Annals of Hematology / Issue 2/2018
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-017-3175-7

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