B-cell recovery following rituximab-based therapy is associated with perturbations in stromal derived factor-1 and granulocyte homeostasis

The occurrence of delayed neutropenia following rituximab is poorly defined and of unknown cause. We hypothesized it may be related to perturbations of stromal derived factor-1 (SDF-19) and granulocyte homeostasis. Late-onset neutropenia (LON) was investigated in 130 patients with untreated aggressi...

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Veröffentlicht in:Blood 2005-08, Vol.106 (3), p.795-802
Hauptverfasser: Dunleavy, Kieron, Hakim, Frances, Kim, Hyun Kyung, Janik, John E., Grant, Nicole, Nakayama, Takayuki, White, Therese, Wright, George, Kwak, Larry, Gress, Ronald, Tosato, Giovanna, Wilson, Wyndham H.
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container_end_page 802
container_issue 3
container_start_page 795
container_title Blood
container_volume 106
creator Dunleavy, Kieron
Hakim, Frances
Kim, Hyun Kyung
Janik, John E.
Grant, Nicole
Nakayama, Takayuki
White, Therese
Wright, George
Kwak, Larry
Gress, Ronald
Tosato, Giovanna
Wilson, Wyndham H.
description The occurrence of delayed neutropenia following rituximab is poorly defined and of unknown cause. We hypothesized it may be related to perturbations of stromal derived factor-1 (SDF-19) and granulocyte homeostasis. Late-onset neutropenia (LON) was investigated in 130 patients with untreated aggressive B-cell lymphoma receiving DA-EPOCH (dose-adjusted etoposide, prednisone, Oncovin [vincristine], cyclophosphamide, and hydroxydaunorubicin) chemotherapy with or without rituximab. All patients were in remission and had no known causes for neutropenia. LON occurred in 6 (8%) of 76 patients receiving rituximab and 0 of 54 patients not receiving rituximab (P = .04). The median onset was 175 days (range, 77-204 days) after treatment with a median duration of 14 days (range, 11-16 days). In a subset of 24 patients, a significant correlation was found between rapid B-cell recovery and granulocyte decline over the 6-month recovery period (R = –0.53; P = .04). Rapid B-cell recovery directly correlated with prerecovery SDF-1 levels (R = 0.65; P = .015) and SDF-1 decline (R = –0.67; P = .013) after recovery. Our results suggest that early B-cell lymphopoiesis is important for B-cell recovery following rituximab, and that perturbation of SDF-1 during B-cell recovery retards neutrophil egress from the bone marrow. These findings illustrate the dual role of SDF-1 in human B-cell and granulocyte homeostasis.
doi_str_mv 10.1182/blood-2004-08-3198
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We hypothesized it may be related to perturbations of stromal derived factor-1 (SDF-19) and granulocyte homeostasis. Late-onset neutropenia (LON) was investigated in 130 patients with untreated aggressive B-cell lymphoma receiving DA-EPOCH (dose-adjusted etoposide, prednisone, Oncovin [vincristine], cyclophosphamide, and hydroxydaunorubicin) chemotherapy with or without rituximab. All patients were in remission and had no known causes for neutropenia. LON occurred in 6 (8%) of 76 patients receiving rituximab and 0 of 54 patients not receiving rituximab (P = .04). The median onset was 175 days (range, 77-204 days) after treatment with a median duration of 14 days (range, 11-16 days). In a subset of 24 patients, a significant correlation was found between rapid B-cell recovery and granulocyte decline over the 6-month recovery period (R = –0.53; P = .04). Rapid B-cell recovery directly correlated with prerecovery SDF-1 levels (R = 0.65; P = .015) and SDF-1 decline (R = –0.67; P = .013) after recovery. Our results suggest that early B-cell lymphopoiesis is important for B-cell recovery following rituximab, and that perturbation of SDF-1 during B-cell recovery retards neutrophil egress from the bone marrow. 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We hypothesized it may be related to perturbations of stromal derived factor-1 (SDF-19) and granulocyte homeostasis. Late-onset neutropenia (LON) was investigated in 130 patients with untreated aggressive B-cell lymphoma receiving DA-EPOCH (dose-adjusted etoposide, prednisone, Oncovin [vincristine], cyclophosphamide, and hydroxydaunorubicin) chemotherapy with or without rituximab. All patients were in remission and had no known causes for neutropenia. LON occurred in 6 (8%) of 76 patients receiving rituximab and 0 of 54 patients not receiving rituximab (P = .04). The median onset was 175 days (range, 77-204 days) after treatment with a median duration of 14 days (range, 11-16 days). In a subset of 24 patients, a significant correlation was found between rapid B-cell recovery and granulocyte decline over the 6-month recovery period (R = –0.53; P = .04). Rapid B-cell recovery directly correlated with prerecovery SDF-1 levels (R = 0.65; P = .015) and SDF-1 decline (R = –0.67; P = .013) after recovery. Our results suggest that early B-cell lymphopoiesis is important for B-cell recovery following rituximab, and that perturbation of SDF-1 during B-cell recovery retards neutrophil egress from the bone marrow. 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Rapid B-cell recovery directly correlated with prerecovery SDF-1 levels (R = 0.65; P = .015) and SDF-1 decline (R = –0.67; P = .013) after recovery. Our results suggest that early B-cell lymphopoiesis is important for B-cell recovery following rituximab, and that perturbation of SDF-1 during B-cell recovery retards neutrophil egress from the bone marrow. These findings illustrate the dual role of SDF-1 in human B-cell and granulocyte homeostasis.</abstract><cop>Washington, DC</cop><pub>Elsevier Inc</pub><pmid>15718416</pmid><doi>10.1182/blood-2004-08-3198</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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identifier ISSN: 0006-4971
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subjects Adult
Aged
Antibodies, Monoclonal - adverse effects
Antibodies, Monoclonal - therapeutic use
Antibodies, Monoclonal, Murine-Derived
Antineoplastic agents
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
B-Lymphocytes - physiology
Biological and medical sciences
Chemokine CXCL12
Chemokines, CXC - blood
Chemokines, CXC - physiology
Clinical Observations, Interventions, and Therapeutic Trials
Drug Evaluation
Female
Granulocytes - physiology
Homeostasis
Humans
Immunotherapy
Kinetics
Lymphoma, B-Cell - complications
Lymphoma, B-Cell - drug therapy
Lymphopoiesis
Male
Medical sciences
Middle Aged
Neutropenia - chemically induced
Neutropenia - etiology
Pharmacology. Drug treatments
Regeneration
Retrospective Studies
Rituximab
title B-cell recovery following rituximab-based therapy is associated with perturbations in stromal derived factor-1 and granulocyte homeostasis
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