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A shortage of antibodies because treatment has wiped out the B cells or plasma cells that make them, as CD19 CAR-T, CD20 antibodies and BCMA therapies deliberately do. It leaves patients prone to infections, sometimes for years, and is managed with immunoglobulin infusions.
Infections are the leading cause of non-relapse death after BCMA and CD19 CAR-T and bispecific antibodies; hypogammaglobulinaemia, prolonged cytopenias, T-cell dysfunction and steroids for CRS all contribute. Management includes IVIG for recurrent infections or IgG <4 g/L, prophylaxis against Pneumocystis, herpes viruses and sometimes fungi, CMV monitoring, and vaccination (non-live; responses are blunted, so household contacts should be vaccinated). Rituximab causes hypogammaglobulinaemia after repeated courses and hepatitis B reactivation. Persistent B-cell aplasia after CD19 CAR-T is also a useful sign that the CAR-T cells remain active.
Backbone ribbon from PDB 6VJA. RCSB PDB 6VJA. The ribbon widens where the chain is folded into a regular pattern and narrows where it is a loose loop.
Showing the molecule this term concerns: Rituximab.
Shares Nodal marginal zone lymphoma, Splenic marginal zone lymphoma, Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), Relapsed and refractory classical Hodgkin lymphoma.
Shares Relapsed and refractory classical Hodgkin lymphoma, Early-stage classical Hodgkin lymphoma (stage I to II), Advanced-stage classical Hodgkin lymphoma (stage III to IV), Waldenström macroglobulinaemia.
Shares Nodal marginal zone lymphoma, Splenic marginal zone lymphoma, Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), Relapsed and refractory classical Hodgkin lymphoma.
Shares Cytopenias and myelosuppression, Low antibodies and infection risk for years after anti-CD20 and bispecific antibodies, Nodal marginal zone lymphoma, Splenic marginal zone lymphoma.
Shares Relapsed and refractory classical Hodgkin lymphoma, Early-stage classical Hodgkin lymphoma (stage I to II), Advanced-stage classical Hodgkin lymphoma (stage III to IV), Waldenström macroglobulinaemia.
Shares Nodal marginal zone lymphoma, Splenic marginal zone lymphoma, Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), Relapsed and refractory classical Hodgkin lymphoma.
Shares Nodal marginal zone lymphoma, Splenic marginal zone lymphoma, Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), Relapsed and refractory classical Hodgkin lymphoma.
Shares Waldenström macroglobulinaemia, Marginal zone lymphoma, Burkitt lymphoma, Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma).