Dysfunctional Immune System Reconstitution After Rituximab Exposure In Utero

Rebecca Clark; Diana Lindsey; Susan Whiteway; Cecilia Mikita; Kenneth Lieuw

doi:10.1097/MPH.0000000000001871

Dysfunctional Immune System Reconstitution After Rituximab Exposure In Utero

J Pediatr Hematol Oncol. 2021 May 1;43(4):e601-e604. doi: 10.1097/MPH.0000000000001871.

Authors

Rebecca Clark¹, Diana Lindsey², Susan Whiteway¹, Cecilia Mikita², Kenneth Lieuw³

Affiliations

¹ Department of Pediatric Hematology and Oncology, Brooke Army Medical Center.
² Departments of Allergy and Immunology.
³ Pediatric Hematology and Oncology, Walter Reed National Military Medical Center.

PMID: 32590421
DOI: 10.1097/MPH.0000000000001871

Abstract

Rituximab is an antibody that binds to B-lymphocytes and is increasingly used during pregnancy. As an immunoglobulin G, it will transfer across the placenta. Previous case reports describe a diversity of clinical presentations in neonates born following rituximab exposure in utero. Our case is the first to offer the long-term experience in the care of an infant with severe neutropenia and prolonged profound hypogammaglobulinemia and class-switching B cell defect after in utero rituximab exposure.

Publication types

Case Reports

MeSH terms

Agammaglobulinemia / chemically induced*
Agammaglobulinemia / immunology
Antineoplastic Agents, Immunological / adverse effects*
Antineoplastic Agents, Immunological / therapeutic use
B-Lymphocytes / drug effects
B-Lymphocytes / immunology
Female
Humans
Immune Reconstitution
Infant, Newborn
Middle Aged
Neutropenia / chemically induced*
Neutropenia / immunology
Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
Pregnancy
Pregnancy Complications, Neoplastic / drug therapy*
Prenatal Exposure Delayed Effects / chemically induced*
Prenatal Exposure Delayed Effects / immunology
Rituximab / adverse effects*
Rituximab / therapeutic use

Substances

Antineoplastic Agents, Immunological
Rituximab