Rituximab is a monoclonal antibody which targets the CD20 marker. It is usually used in chemotherapy regimens against cells that express CD20, in this case B cells (as in the case of malignant non-Hodgkin's B cell lymphoma). It is also used in the treatment of certain diseases, but also in some clinical trials (as in the case of type 1 diabetes). Of course, the infusion of Rituximab (anti-CD20) would affect all CD20+ cells. My question: Does Rituximab have an effect on normal circulating lymphocytes?
Yes, rituxan can induce prolonged B lymphopenia and expose patient to infectious complications. It has been well documented in most of the oncologic studies. Moreover, Rituxan is used as an immunosuppressive drug for auto immune disorders with a B cell participations such as ITP, RA, etc
Yes! Every CD20-positive cell destroyed by complement-dependent lysis in case of CD20-rituximab interaction.
In fact it is not quite true that all circulating B cells are killed by Rituximab.
Approximately 10% of circulating B cells, CD19 +, CD20 low, are still active even after treatment with metotrexate.
It is these cells that are responsible for the ADA response which follows. Although the majority of B cells have disappeared from the circulating blood, we have reactivated residual B cells with HuBBB, in sufficient quantity to identify cells producing ADA, and then clone a number of them.
This is also the case with Infliximab and RoActemra which although causing a significant lymphopenia let escape B cells capable of producing ADA directed against these drugs.
Dear Mourab,
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You get a deep, lasting B cell lymphopenia.
You can also get neutropenia, but that is another problem.
Of course it has. All CD20+ cells are affected by monoclonal antibody rituximab, or other anti CD20 monoclonal antibodies, as well-obinutuzumab, ofatumumab, veltuzumab. If you look at the basic blood cell count you couls see lymphopenia in most of patients treated with rituximab. This lymphopenia is deep and long lasting. There some publications that pointed to higher risk for lymphoma relaps if lymphopenia persist longer than 6 months after rituximab treatment.
Agree, Rituximab and other anti-CD20-therapy usually cause deep and long-lasting B-cell depletion (sometimes even more than one year after stopping the therapy). However, in rare cases, you may get as well few circulating CD19+-positive cells with low or even negative CD20
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