Patterns of development of immune complications in patients with lymphoproliferative diseases receiving rituximab therapy

Rituximab is a synthetic (genetically engineered) chimeric monoclonal antibody that has occupied its niche of application not only in relation to lymphoproliferative diseases (non-Hodgkin lymphomas and chronic lymphocytic leukemia), but also in relation to a number of other diseases. However, when using this drug, a number of complications occur, including immune ones. A certain pattern of development of immune complications has been revealed depending on the stage of therapy. During rituximab therapy, cases of transient decrease in B-lymphocytes or immunoglobulin levels are often reported, which are leveled 6-12 months after the end of treatment with this drug. It also describes the development of prolonged and persistent neutropenia, which develops delayed in relation to the end of therapy. There are risk factors associated with immunological complications: male gender, Caucasian race, age over 50 years, immunocompromised conditions (immunosuppressive therapy, primary and secondary immunodeficiency). The most effective methods of prevention include: detection of severe infectious complications in the last 6 months of patient follow-up, detection of a critical decrease in the level of class G immunoglobulins (less than 4 g /l) and its correction by immunosuppression therapy; determination of the content of mature B lymphocytes in peripheral blood and preventive sanitation of foci of chronic infection.