ArticleArthritis & rheumatology (Hoboken, N.J.)2021
Incidence, Clinical Features, and Outcomes of Late-Onset Neutropenia From Rituximab for Autoimmune Disease.
Article in Arthritis & rheumatology (Hoboken, N.J.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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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
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Pooled it
- Late-Onset Neutropenia After Rituximab in Multiple Sclerosis: Incidence, Predictors, and Outcomes in a Retrospective Multicenter Cohort.Neurology(R) neuroimmunology & neuroinflammation · 2026Article
- Infection prophylaxis following anti-CD20 monoclonal antibodies in childhood kidney diseases.Pediatric nephrology (Berlin, Germany) · 2026Review
- Neutropenic events associated with new anticancer treatments, from pathophysiology to practice: a scoping review-NEW Group (Neutropenic Events Working Group).Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Depleting Autoreactive B‑Cells Using Targeted Photodynamic Therapy.ACS pharmacology & translational science · 2025Article
- [Severe late-onset neutropenia after rituximab administration].Zeitschrift fur Rheumatologie · 2025Article
- Persistent B Cell Depletion After Rituximab for Autoimmune and Glomerular Diseases: A Case Series.Kidney international reports · 2025Article
- Review
- Article
- Late-onset Neutropenia after Rituximab Treatment for MPO-ANCA-associated Vasculitis.Internal medicine (Tokyo, Japan) · 2025Article
- Late-onset severe neutropenia in patients with relapsing remitting multiple sclerosis treated with ocrelizumab: case report and literature review.Frontiers in neuroscience · 2025Article
- Building alliances for early detection of immunodeficiencies: from primary care to hematology.Frontiers in immunology · 2025Review
- Safety and Tolerability of Rituximab in the Treatment of Systemic Sclerosis.Doklady. Biochemistry and biophysics · 2024Article
- Effect of Antigen Valency on Autoreactive B-Cell Targeting.Molecular pharmaceutics · 2024Article
- Risk of Severe Infections Secondary to the Use of Targeted Therapies in Hematological Malignancies.Cureus · 2024Review
- An update on the incidence, risk factors and mechanisms of rituximab-associated neutropenia.Archives of medical science : AMS · 2024Article
- Comparative Effectiveness of Rituximab- Versus Cyclophosphamide-Based Remission Induction Strategies in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis for the Risk of Kidney Failure and Mortality.Arthritis & rheumatology (Hoboken, N.J.) · 2023Article
- [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
- Risk of Infections Secondary to the Use of Targeted Therapies in Hematological Malignancies.Life (Basel, Switzerland) · 2023Review
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
objectiveLate-onset neutropenia (LON) is an underrecognized complication of rituximab treatment. We undertook this study to describe its incidence, risk factors, clinical features, management, and recurrence.
methodsWe conducted a single-center retrospective cohort study of 738 adult patients with autoimmune disease who were treated with rituximab to induce continuous B cell depletion. The primary outcome measure was LON, defined as an unexplained absolute neutrophil count of <1,000 cells/µl during B cell depletion. Secondary outcome measures included incidental diagnosis, fever, sepsis, filgrastim use, and recurrent LON. We assessed predictors of LON using Cox proportional hazards regression models. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated.
resultsWe identified 107 episodes of LON in 71 patients. The cumulative incidence at 1 year of B cell depletion therapy was 6.6% (95% CI 5.0-8.7). The incidence rate during the first year was higher compared to thereafter (7.2 cases per 100 person-years [95% CI 5.4-9.6] versus 1.5 cases per 100 person-years [95% CI 1.0-2.3]). Systemic lupus erythematosus and combination therapy with cyclophosphamide were each independently associated with an increased risk of LON (adjusted HR 2.96 [95% CI 1.10-8.01] and 1.98 [95% CI 1.06-3.71], respectively). LON was not observed in minimal change disease or focal segmental glomerulosclerosis. The majority of episodes (59.4%) were asymptomatic. Fever and sepsis complicated 31.3% and 8.5% of episodes, respectively. Most patients (69%) were treated with filgrastim. Rituximab rechallenge occurred in 87% of patients, of whom 21% developed recurrent LON.
conclusionLON is common and often incidental. Most cases are reversible and respond well to filgrastim. However, LON can be associated with serious infections and thus warrants vigilant monitoring.
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