Rituxan induced hypogammaglobulinemia – pro
Rituxan can cause long-lasting immunodeficiency, IGG levels. A recent review, and it defined hypogammaglobulinemia as less that 500 and looked only at those patients,said this: ” evidence has been provided suggesting that IgRT is effective in most patients with SAD. Nonetheless, cost-effectiveness advantage of initiating an IgRT in subjects with SAD has been criticized by some authors. To provide a conclusive reply to this criticism, a question should be definitively answered by future studies: what criteria should be used to identify patients in whom prophylactic IgRT may help to decrease infectious risk? At present IgG levels represent the only parameter employed to this aim. A better selection of patients in which IgRT is needed can lead us to limit the perhaps too extended use of IgRT in SAD.”
Nicolò Compagn et al, Immunoglobulin Replacement Therapy in Secondary Hypogammaglobulinemia. Front Immunol. 2014; 5: 626.
Deane S, Selmi C, Naguwa SM, Teuber SS, Gershwin ME. Common variable immunodeficiency: etiological and treatment issues. Int Arch Allergy Immunol. 2009;150(4):311-24.
Work Group Report of the American Academy of Allergy, Asthma & Immunology
Update on the use of immunoglobulin in human disease: A review of evidence. J Allergy Clin Immunol 2017;139:S1-46.