Incidence of Infectious Disease and Malignancies After Rituximab Therapy in Kidney-Transplant Recipients.
1Nephrology, Charité, Berin, Germany
2Rheumatology, Charité, Berlin, Germany.
Meeting: 2016 American Transplant Congress
Abstract number: D144
Keywords: Antilymphocyte antibodies, Infection
Session Information
Date: Tuesday, June 14, 2016
Session Name: Poster Session D: Kidney Immunosuppression: Novel Agents
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
BACKGROUND:
Rituximab off-label use is common in solid organ transplantation. It is used in patients with antibody-mediated rejections, in AB0-incompatible renal transplantation, in pre-sensitized organ recipients or the treatment of recurrence of focal segmental glomerulosclerosis (FSGS). Long-term outcomes data especially regarding infectious complications are missing.
PATIENTS AND METHODS:
A retrospective single center observational study was conducted. 63 adult kidney-transplant recipients who have received rituximab between 2006 and 2014 were enrolled in the study. Patients received rituximab for AB0-incompatible renal transplantation, eecurrence of FSGS, antibody-mediated rejection or desensitization.
Age (years) | 44 (20-70) |
Gender (M/F) | 38/35 |
Number of transplantations | 1,30 ± 0,66 |
Anti-IL2R blocker induction therapy (Y/N) | 33/30 |
Plasma exchange associated with rituximab (Y/N) | 37/26 |
Steroid pulse associated with rituximab (Y/N) | 56/63 |
Eculizumab associated with rituximab (Y/N) | 2/61 |
IVIG associated with rituximab (Y/N) | 20/42 |
Bortezomib associated with rituximab (Y/N) | 15/48 |
RESULTS:
Median follow-up was 42 (1-109) months. The incidence of severe infections needing in hospital treatment was 57% overall. The median time between the first rituximab infusion and the first infection was 4 (1-48) months. Severe bacterial infections were observed in 44.4% of cases, severe viral infections in 7.9 % of cases, severe fungal in 4,8% of cases. Severe combined (viral, bacterial and fungal) infections 6.4% cases. Of the 7 patients (11.1%) who died in the observational period, 2 died from infectious complications. In the observational period there was one case of squamous cell carcinoma, no other malignancies were observed. Bacterial infections observed were due to sepsis with positive blood cultures (n=19), urinary tract infection (n=36), pneumonia (n=10), catheter-associated infection (n=2), erysipel skin infection (n=2), wound infection (n=2), colitis (n=2), otitis (n=2), sakroileitis (n=1) and atypical mycobacteriosis.
CONCLUSION:
Consistent with previous data a high proportion of infections were observed after rituximab use in kidney-transplant recipients. Most infections occur within six months after rituximab infusion. With more than 3 years of follow-up we were able to document a low incidence of secondary malignancies after rituximab use.
CITATION INFORMATION: Schrezenmeier E, Doerner T, Staeck O, Budde K, Halleck F. Incidence of Infectious Disease and Malignancies After Rituximab Therapy in Kidney-Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Schrezenmeier E, Doerner T, Staeck O, Budde K, Halleck F. Incidence of Infectious Disease and Malignancies After Rituximab Therapy in Kidney-Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/incidence-of-infectious-disease-and-malignancies-after-rituximab-therapy-in-kidney-transplant-recipients/. Accessed August 20, 2018.« Back to 2016 American Transplant Congress