FRI0155 Rituximab Associated Late Onset Neutropaenia: Safety of Retreatment Rituximab Therapy in 900 Patients

BackgroundNeutropaenia is reported as a complication of rituximab (RTX) therapy for B cell malignancies with an incidence of 3-27%. [1] Data in rheumatic diseases are more limited and the optimal management of these patients has not been defined.ObjectivesThe aims of this study were to determine the (1) incidence of rituximab-associated neutropaenia; (2) rates of infection; (3) time for recovery; (4) safety of retreatment with RTX, as a basis for management guidelines.MethodsWe conducted an observational study on all patients treated with RTX in a single centre between 2003 and 2014. Each cycle consisted of 2x1000mg (with a small percentage receiving half dose if in remission), repeated either on clinical relapse or pre-emptively. RAN was defined as an absolute neutrophil count 1.0×109/L), moderate (0.5-1.0×109/L) and severe (0.5 x 109/L was associated with infection. Irrespective of the degree of neutropaenia, all patients responded to RTX for the original indication. 26 (72.2%) of the episodes had complete B cell depletion as assessed by highly sensitive FACS. Of the patients who were retreated with RTX 2x1000mg: 11/19 had no recurrence of neutropaenia, 8/19 had mild neutropaenia in next cycle, and 4 patients had again recurrence of mild neutropenia. All the subsequent episodes were without