B cell depletion in infants after intra uterine exposure to immunomodulating chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP): A case series and review of the literature

J.W. Wieringa; Mirjam Esser; Jan Damoiseaux; Gertjan Driessen; Joyce van Beers

doi:10.1016/j.clicom.2023.06.004

B cell depletion in infants after intra uterine exposure to immunomodulating chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP): A case series and review of the literature

J.W. Wieringa^*, Mirjam Esser, Jan Damoiseaux, Gertjan Driessen, Joyce van Beers

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

The immunomodulating chemotherapeutic drugs rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) have the ablity to pass the placenta during pregnancy and might affect the development of the immune system of exposed infants. In particular rituximab causes a transient and almost complete depletion of CD20 expressing B cells and can remain detectable in the infant several months after birth.

In this case series we report on the clinical and immunological outcomes of 3 infants exposed to R-CHOP during pregnancy because of maternal B-cell lymphoma and review other cases that have been published. We show that R-CHOP in pregnancy has a profound effect on the immune system in the first year of life, including B-cell lymphopenia, hypogammaglobinemia, neutropenia and decreased response to immunization. Immune monitoring of exposed infants is warranted.

Original language	English
Pages (from-to)	1-6
Number of pages	6
Journal	Clinical Immunology Communications
Volume	4
DOIs	https://doi.org/10.1016/j.clicom.2023.06.004
Publication status	Published - 15 Dec 2023

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Wieringa, J. W., Esser, M., Damoiseaux, J., Driessen, G., & van Beers, J. (2023). B cell depletion in infants after intra uterine exposure to immunomodulating chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP): A case series and review of the literature. Clinical Immunology Communications, 4, 1-6. https://doi.org/10.1016/j.clicom.2023.06.004

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title = "B cell depletion in infants after intra uterine exposure to immunomodulating chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP): A case series and review of the literature",

abstract = "The immunomodulating chemotherapeutic drugs rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) have the ablity to pass the placenta during pregnancy and might affect the development of the immune system of exposed infants. In particular rituximab causes a transient and almost complete depletion of CD20 expressing B cells and can remain detectable in the infant several months after birth.In this case series we report on the clinical and immunological outcomes of 3 infants exposed to R-CHOP during pregnancy because of maternal B-cell lymphoma and review other cases that have been published. We show that R-CHOP in pregnancy has a profound effect on the immune system in the first year of life, including B-cell lymphopenia, hypogammaglobinemia, neutropenia and decreased response to immunization. Immune monitoring of exposed infants is warranted.",

author = "J.W. Wieringa and Mirjam Esser and Jan Damoiseaux and Gertjan Driessen and {van Beers}, Joyce",

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Wieringa, JW, Esser, M , Damoiseaux, J , Driessen, G & van Beers, J 2023, 'B cell depletion in infants after intra uterine exposure to immunomodulating chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP): A case series and review of the literature', Clinical Immunology Communications, vol. 4, pp. 1-6. https://doi.org/10.1016/j.clicom.2023.06.004

B cell depletion in infants after intra uterine exposure to immunomodulating chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP): A case series and review of the literature. / Wieringa, J.W.; Esser, Mirjam ; Damoiseaux, Jan et al.
In: Clinical Immunology Communications, Vol. 4, 15.12.2023, p. 1-6.

Research output: Contribution to journal › Article › Academic › peer-review

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