SynthesisBMC medicine2011
Risk of infection in patients with lymphoma receiving rituximab: systematic review and meta-analysis.
Synthesis in BMC medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 3 syntheses or guidelines pooled it, 90 citations in OpenAlex.
- Efficacy and safety of new anti-CD20 monoclonal antibodies versus rituximab for induction therapy of CD20Scientific reports · 2021Pooled it
- Guideline
- Rituximab, ofatumumab and other monoclonal anti-CD20 antibodies for chronic lymphocytic leukaemia.The Cochrane database of systematic reviews · 2012Pooled it
- Effect of rituximab on immune status in children with mature B-cell non-Hodgkin lymphoma: a prespecified secondary analysis of the Inter-B-NHL Ritux 2010 trial.The Lancet. Haematology · 2023Trial
- Rituximab in idiopathic membranous nephropathy.Journal of the American Society of Nephrology : JASN · 2012Trial
- Trial
- Article
- Association of rituximab use with adverse events in adults with lymphoma or autoimmune disease: a single center experience.Frontiers in medicine · 2025Article
- Managing Invasive Fungal Infections During Allogeneic Hematopoietic Transplantation: A 2025 Update.Mediterranean journal of hematology and infectious diseases · 2025Review
- Hypogammaglobulinemia and Infection Events in Patients with Autoimmune Diseases Treated with Rituximab: 10 Years Real-Life Experience.Journal of clinical immunology · 2024Article
- Article
- Modeling and affinity maturation of an anti-CD20 nanobody: a comprehensive in-silico investigation.Scientific reports · 2023Article
- Hepatotoxicity during legacy cancer chemotherapy in patients infected with hepatitis C virus: A retrospective cohort study.Canadian liver journal · 2022Article
- Use of modeling and simulation to predict the influence of triazole antifungal agents on the pharmacokinetics of zanubrutinib and acalabrutinib.Frontiers in pharmacology · 2022Article
- Clinical Characteristics and Prognostic Factors in Primary Breast Diffuse Large B-Cell Lymphoma.Mediterranean journal of hematology and infectious diseases · 2022Article
- Article
- Invasive Fungal Infections and Targeted Therapies in Hematological Malignancies.Journal of fungi (Basel, Switzerland) · 2021Review
- Invasive Fungal Diseases in Children with Hematological Malignancies Treated with Therapies That Target Cell Surface Antigens: Monoclonal Antibodies, Immune Checkpoint Inhibitors and CAR T-Cell Therapies.Journal of fungi (Basel, Switzerland) · 2021Review
- Infection risk in autoimmune hematological disorders with low-dose rituximab treatment.Journal of clinical laboratory analysis · 2020Article
- Considerations for the Treatment of Inflammatory Neuro-Ophthalmologic Disorders During the COVID-19 Pandemic.Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe addition of Rituximab (R) to standard chemotherapy (C) has been reported to improve the end of treatment outcome in patients affected by CD-20 positive malignant lymphomas (CD20+ ML). Nevertheless, given the profound and prolonged immunosuppression produced by R there are concerns that severe infections may arise. A systematic review and meta-analysis were performed to determine whether or not the addition of R to C may increase the risk of severe infections in adults undergoing induction therapy for CD20+ ML.
methodsOnly randomised controlled trials comparing R-C to C standard alone in adult patients with CD20+ ML were included. Meta-analysis was performed on overall incidence of severe infection, risk of dying as the consequence of infection, risk of febrile neutropenia, risk of severe leucopenia, risk of severe granulocytopenia and overall response assuming a fixed effect model. Heterogeneity was investigated, if present and I2 >20%, according to several predefined baseline characteristics of the study populations.
resultsSeveral relevant results have emerged. First, the addition of R to standard C does not increase the overall risk of severe infections (RR = 1.00; 95% CI 0.87 to 1.14) nor does it increase the risk of dying as a consequence of infection (RR = 1.60; 95% CI 0.68 to 3.75). Second, we confirmed that the addition of R to standard C increases the proportion of overall response (RR = 1.12; 95% CI 1.09 to 1.15), but it also increases the risk of severe leucopenia (RR = 1.24; 95% CI 1.12 to 1.37) and granulocytopenia (RR = 1.07; 95% CI 1.02 to 1.12).
conclusionsR-C is superior to standard C in terms of overall response and it does not increase the overall incidence of severe infection. However, data on special groups of patients (for example, HIV positive subjects and HBV carriers) are lacking. In our opinion more studies are needed to explore the potential effect of R on silent and chronic viral infections.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.