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The role of BAFF and G-CSF for rituximab-induced late-onset neutropenia (LON) in lymphomas.
- Source :
-
Medical oncology (Northwood, London, England) [Med Oncol] 2021 May 18; Vol. 38 (6), pp. 70. Date of Electronic Publication: 2021 May 18. - Publication Year :
- 2021
-
Abstract
- Mechanisms for late-onset neutropenia (LON) after rituximab treatment are poorly defined both for non-Hodgkin lymphoma (NHL) and for autoimmune disorders. We performed a case-control analysis of a prospective cohort of 169 evaluable consecutive rituximab-treated NHL patients to assess cytokines involved in neutro- and lymphopoiesis (G-CSF, SDF1, BAFF, APRIL) and inflammation (CRP) as possible LON mechanisms. Fifteen patients (9%) developed LON (peripheral blood /PB/ absolute neutrophil counts /ANC/ < 0.5 G/L, all with marked depletion of CD20 <superscript>+</superscript> B-lymphocytes in bone marrows); they were compared with 20 matched NHL controls without LON. At start of LON, significantly higher PB G-CSF and BAFF levels (P = 0.0004 and 0.006, respectively), as well as CRP rises were noted compared to controls; these G-CSF and BAFF and most CRP values returned to levels of the controls in post-LON samples. G-CSF (but not BAFF) changes correlated to CRP rises (but not to ANC levels). BAFF levels correlated significantly to absolute monocyte counts and PB large granular lymphocyte counts (but not to ANC, C-CSF or CRP values). No changes of SDF1 or APRIL levels were noted. Neither LON cases nor controls displayed anti-neutrophil autoantibodies. Collectively, LON in NHL patients was timewise related to transient bursts of blood G-CSF and BAFF concentrations, suggesting that these neutro- and lymphopoiesis growth factors play a role in emergence of rituximab-induced LON, and that inflammation may be a trigger for G-CSF production during LON.
- Subjects :
- Adult
Aged
Aged, 80 and over
Autoantibodies blood
Autoantibodies immunology
Case-Control Studies
Chemokine CXCL12 blood
Female
Humans
Male
Middle Aged
Neutrophils immunology
Prospective Studies
Receptors, Immunologic blood
Tumor Necrosis Factor Ligand Superfamily Member 13 blood
Antineoplastic Agents, Immunological adverse effects
B-Cell Activating Factor blood
Granulocyte Colony-Stimulating Factor blood
Lymphoma, Non-Hodgkin drug therapy
Neutropenia chemically induced
Rituximab adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1559-131X
- Volume :
- 38
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Medical oncology (Northwood, London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 34003398
- Full Text :
- https://doi.org/10.1007/s12032-021-01516-8