Rituximab-related viral infections in lymphoma patients
Rituximab-related viral infections in lymphoma patients
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DOI：
10.1080/10428190701411441
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发表时间：
2007-01-01
影响因子：
2.6
通讯作者：
Barista, Ibrahim
中科院分区：
文献类型：
--
作者：
Aksoy, Sercan;Harputluoglu, Hakan;Barista, Ibrahim
近年来，一种人/鼠嵌合单克隆抗体利妥昔单抗（rituximab）已成功地用于治疗B细胞非霍奇金淋巴瘤和一些自身免疫性疾病。然而，在文献中报告了几种与利妥昔单抗相关的病毒感染，但没有很好地表征。为了进一步研究这一主题，通过Medline确定了相关的英语语言研究。先前报告了64例利妥昔单抗治疗后发生严重病毒感染的病例。病例的中位年龄为61岁（范围：21 - 79岁）。从利妥昔单抗治疗开始到病毒感染诊断的中位时间为5.0个月（范围：1 - 20）。最常见的病毒感染是B肝炎病毒（HBV）（39.1%，n = 25）、巨细胞病毒（CMV）（23.4%，n = 15）、水痘-带状疱疹病毒（VZV）（9.4%，n = 6）和其他（28.1%，n = 18）。在HBV感染的患者中，13例（52.0%）死于肝功能衰竭。在39例HBV以外的病毒感染病例中，13例死于这些特定感染。在这项研究中，约50%的利妥昔单抗相关的HBV感染导致死亡，而这在其他感染的病例中仅占33%。应建议对接受利妥昔单抗治疗的患者密切监测病毒感染，特别是HBV和CMV。
Recently, a human/mouse chimeric monoclonal antibody, rituximab, has been successfully used to treat cases of B-cell non-Hodgkin's lymphoma and some autoimmune diseases. However, several viral infections related to rituximab have been reported in the literature, but were not well characterized. To further investigate this topic, relevant English language studies were identified through Medline. There were 64 previously reported cases of serious viral infection after rituximab treatment. The median age of the cases was 61 years (range: 21 - 79). The median time period from the start of rituximab treatment to viral infection diagnosis was 5.0 months (range: 1 - 20). The most frequently experienced viral infections were hepatitis B virus (HBV) (39.1%, n = 25), cytomegalovirus infection (CMV) (23.4%, n = 15), varicella-zoster virus (VZV) ( 9.4%, n = 6), and others (28.1%, n = 18). Of the patients with HBV infections, 13 (52.0%) died due to hepatic failure. Among the 39 cases that had viral infections other than HBV, 13 died due to these specific infections. In this study, about 50% of the rituximab-related HBV infections resulted in death, whereas this was the case in only 33% of the cases with other infections. Close monitoring for viral infection, particularly HBV and CMV, in patients treated with rituximab should be recommended.