Anti-CD20-Mediated B Cell Depletion Is Associated with Reduced Osteoclastogenic Signals and Bone Mass Preservation: Clinical Observation in Patients with Follicular Lymphoma Supplemented By Animal Studies in a Murine Model

Background and aims:Immunotherapy with anti-CD20-specific antibodies (e.g. rituximab), has become the standard of care for B cell lymphoproliferative disorders and many autoimmune diseases. Despite previously demonstrated role for B cells in bone metabolism, the effect of anti-CD20-mediated B cell depletion on bone mass in human patients has not been thoroughly studied. For example, in rheumatological patients the effect of rituximab on bone mass yielded conflicting results, while in lymphoma patients it has not yet been described. Here, we describe the effect of treatment with anti-CD20-specific antibodies on bone mass in a cohort of patients with follicular lymphoma and propose a plausible mechanism using murine model.