Rituximab Induced Neutropenia Save

In reviewing submitted abstracts for the 2014 ACR meeting, I was surprised by several abstracts focusing on neutropenia in patients receiving rituximab. One of these has recently been published by the French AIR registry, who examined the frequency of neutropenia among 2,624 patients with refractory autoimmune diseases (1,975 RA patients) who had been treated with rituximab. (Citation source http://buff.ly/1Trxv76)

Of the 40 patients with new onset neutropenia, 25 with RA (1.3%) and 15 with other autoimmune diseases (2.3%), neutropenia occurred a median of 4.5 months after the last infusion of rituximab. Neutropenia resulted in opportunistic infection in 5 of 40 patient (20%) that required treatment, including granulocyte colony-stimulating factor therapy. Of the few (13) who stopped RTX for neutropenia and were later retreated, 3/13 had recurrence of neutropenia. It appears this adverse event may be more common in RA and rheumatic disease than in those with hematologic disorders.

Photo credit: "Neutropenia" by Roberto J. Galindo - Own Work: Foto tomada por Roberto J. Galindo. Licensed under CC BY-SA 3.0 via Wikimedia Commons