ArticlePloS one2012
Impact of rituximab on immunoglobulin concentrations and B cell numbers after cyclophosphamide treatment in patients with ANCA-associated vasculitides.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers.
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Who cites it
64 citing papers in PubMed, 138 citations in OpenAlex.
- Long-term Outcomes After Rituximab Treatment for Patients With Systemic Sclerosis: Follow-up of the DESIRES Trial With a Focus on Serum Immunoglobulin Levels.JAMA dermatology · 2023Trial
- Long-term follow-up of serum immunoglobulin levels in blinatumomab-treated patients with minimal residual disease-positive B-precursor acute lymphoblastic leukemia.Blood cancer journal · 2014Trial
- Infection prophylaxis following anti-CD20 monoclonal antibodies in childhood kidney diseases.Pediatric nephrology (Berlin, Germany) · 2026Review
- Cyclophosphamide Plus Rituximab Versus Cyclophosphamide in Antineutrophil Cytoplasmic Antibody-associated Vasculitis With Kidney Involvement: A Retrospective Cohort Study in China.Kidney medicine · 2026Article
- Hypogammaglobulinaemia in patients with ANCA-associated vasculitis treated with rituximab.Frontiers in medicine · 2026Article
- Effects of Limosilactobacillus fermentum KBL375 on Immune Enhancement and Gut Microbiota Composition in Cyclophosphamide-Induced Immunosuppressed Mice.Probiotics and antimicrobial proteins · 2025Article
- Exploring the depths of hypogammaglobulinemia in lymphoid malignancies: Pathophysiology, clinical implications, management options, and future directions.Blood reviews · 2025Review
- Elevated Fab glycosylation of autoantibodies maintained during B cell depletion therapy.Scientific reports · 2025Article
- Impact of rituximab on IgG and IgM levels in patients with autoimmune bullous diseases: a cohort study.Archives of dermatological research · 2025Article
- Two Decades Rituximab Therapy in Anti-Neutrophil Cytoplasmic Antibody Associated Vasculitis.Current drug targets · 2025Review
- Defects in B-lymphopoiesis and B-cell maturation underlie prolonged B-cell depletion in ANCA-associated vasculitis.Annals of the rheumatic diseases · 2024Article
- B cell subsets reconstitution and immunoglobulin levels in children and adolescents with B non-Hodgkin lymphoma after treatment with single anti CD20 agent dose included in chemotherapeutic protocols: single center experience and review of the literature.Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia · 2024Review
- Long-term surveillance study of rituximab originator treated patients with granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA).Rheumatology advances in practice · 2024Article
- [Diagnosis and therapy of granulomatosis with polyangiitis and microscopic polyangiitis-2023: consensus of the Austrian society of nephrology (ÖGN) and Austrian society of rheumatology (ÖGR)].Wiener klinische Wochenschrift · 2023Article
- Hypogammaglobulinemia, late-onset neutropenia, and infections following rituximab.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2023Review
- Adding low dose cyclophosphamide to rituximab for remission-induction may prolong relapse-free survival in patients with ANCA vasculitis: A retrospective study.Journal of translational autoimmunity · 2023Article
- Case report: Persistent hypogammaglobulinemia in thymoma-associated myasthenia gravis: the impact of rituximab or Good's syndrome?Frontiers in neurology · 2023Article
- Rituximab-associated hypogammaglobulinemia in ANCA-associated vasculitis: Incidence and time course.European journal of rheumatology · 2022Article
- IgM Deficiency in Autoimmune Blistering Mucocutaneous Diseases Following Various Treatments: Long Term Follow-Up and Relevant Observations.Frontiers in immunology · 2021Article
- Rituximab Associated Hypogammaglobulinemia in Autoimmune Disease.Frontiers in immunology · 2021Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the impact of immunosuppressive therapy with cyclophosphamide (CYC) and rituximab (RTX) on serum immunoglobulin (Ig) concentrations and B lymphocyte counts in patients with ANCA-associated vasculitides (AAVs).
methodsRetrospective analysis of Ig concentrations and peripheral B cell counts in 55 AAV patients.
resultsCYC treatment resulted in a decrease in Ig levels (median; interquartile range IQR) from IgG 12.8 g/L (8.15-15.45) to 9.17 g/L (8.04-9.90) (p = 0.002), IgM 1.05 g/L (0.70-1.41) to 0.83 g/L (0.60-1.17) (p = 0.046) and IgA 2.58 g/L (1.71-3.48) to 1.58 g/L (1-31-2.39) (p = 0.056) at a median follow-up time of 4 months. IgG remained significantly below the initial value at 14.5 months and 30 months analyses. Subsequent RTX treatment in patients that had previously received CYC resulted in a further decline in Ig levels from pre RTX IgG 9.84 g/L (8.71-11.60) to 7.11 g/L (5.75-8.77; p = 0.007), from pre RTX IgM 0.84 g/L (0.63-1.18) to 0.35 g/L (0.23-0.48; p<0.001) and from pre RTX IgA 2.03 g/L (1.37-2.50) to IgA 1.62 g/L (IQR 0.84-2.43; p = 0.365) 14 months after RTX. Treatment with RTX induced a complete depletion of B cells in all patients. After a median observation time of 20 months median B lymphocyte counts remained severely suppressed (4 B-cells/µl, 1.25-9.5, p<0.001). Seven patients (21%) that had been treated with CYC followed by RTX were started on Ig replacement because of severe bronchopulmonary infections and serum IgG concentrations below 5 g/L.
conclusionsIn patients with AAVs, treatment with CYC leads to a decline in immunoglobulin concentrations. A subsequent RTX therapy aggravates the decline in serum immunoglobulin concentrations and results in a profoundly delayed B cell repopulation. Surveying patients with AAVs post CYC and RTX treatment for serum immunoglobulin concentrations and persisting hypogammaglobulinemia is warranted.
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