Secondary hypogammaglobulinemia and lymphocytopenia in patients with inflammatory neurological diseases on anti-CD20 therapy: risk of infection and infection-related mortality

接受抗CD20治疗的炎症性神经系统疾病患者继发性低丙种球蛋白血症和淋巴细胞减少症:感染风险和感染相关死亡率

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Abstract

Although anti-CD20 treatments are effective in inflammatory neurological diseases, they have some risks, especially infections. Determining the predictor factors of infection helps risk management in patients receiving anti-CD20 treatments. The effect of ocrelizumab (OCR) and rituximab (RTX) associated hypogammaglobulinemia (HGG) and lymphopenia on infection risk is controversial. The aim of this study to evaluate relationship between HGG and lymphocytopenia and infection risk and infection-related mortality in patients under RTX and OCR treatments and also compare these parameters between two agents. In our findings no relationship was found between HGG and infection risk in patients receiving OCR and RTX. In the RTX group, a significant relationship was detected between lymphocytopenia and severe infection. And, all three patients with infection-related mortality under rituximab treatment had HGG. No infection-related mortality was happened in OCR treatment. While lymphocytopenia and HGG were not detected as significant risk factors for infection, older age, female gender and > 4 EDSS score were determined as risk factors for infection in patients receiving OCR treatment. Identifying factors predicting infection risk may provide better risk management in patients receiving anti-CD20 therapy.

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