Relapse of nephrotic syndrome during post-rituximab peripheral blood B-lymphocyte depletion View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-04-22

AUTHORS

Mai Sato, Koichi Kamei, Masao Ogura, Kenji Ishikura, Shuichi Ito

ABSTRACT

BackgroundRituximab is effective against complicated childhood steroid-dependent nephrotic syndrome (SDNS). Peripheral blood B-lymphocyte (B-cell) depletion is strongly correlated with persistent remission, relapse rarely occurring during B-cell depletion; however, we have encountered several such patients.MethodsWe retrospectively analyzed the characteristics and clinical course of 82 patients with SDNS treated with rituximab from January 2007 to December 2012 in our institution.ResultsSix of 82 patients (7.3%) had relapses during B-cell depletion after receiving rituximab (relapsed group). The remaining 76 patients did not have relapses during B-cell depletion (non-relapsed group). The median time to initial relapse during B-cell depletion was 85 days after receiving rituximab, which is significantly shorter than in the non-relapsed group (410 days, p = 0.0003). The median annual numbers of relapses after receiving rituximab were 2.5 and 0.9 in the relapsed and non-relapsed groups, respectively (p < 0.0001). Five patients in the relapsed group also had a total of 10 relapses after B-cell recovery; their median time from B-cell recovery to initial relapse was significantly shorter than in the non-relapsed group (31 vs. 161 days, p = 0.014). Number of relapses before rituximab, history of steroid resistance, onset age, previous treatment, time to ceasing steroids after rituximab, and duration of B-cell depletion did not differ between the two groups.ConclusionRelapse during B-cell depletion after receiving rituximab suggests that various pathophysiological mechanisms play a part in childhood nephrotic syndrome. More... »

PAGES

110-116

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10157-017-1415-8

DOI

http://dx.doi.org/10.1007/s10157-017-1415-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1085047490

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28434126


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