Dr. Leandro has received honoraria (less than $10,000) from Roche.
Reconstitution of peripheral blood B cells after depletion with rituximab in patients with rheumatoid arthritis
Article first published online: 30 JAN 2006
Copyright © 2006 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 54, Issue 2, pages 613–620, February 2006
How to Cite
Leandro, M. J., Cambridge, G., Ehrenstein, M. R. and Edwards, J. C. W. (2006), Reconstitution of peripheral blood B cells after depletion with rituximab in patients with rheumatoid arthritis. Arthritis & Rheumatism, 54: 613–620. doi: 10.1002/art.21617
- Issue published online: 30 JAN 2006
- Article first published online: 30 JAN 2006
- Manuscript Accepted: 31 OCT 2005
- Manuscript Received: 18 JUN 2005
- GlaxoSmithKline Research and Development Limited
To study the quantitative and phenotypic reconstitution of peripheral blood B cells and its relationship to the dynamics of clinical response in patients with rheumatoid arthritis (RA) following B cell depletion with rituximab.
Twenty-four patients with active RA treated with rituximab were studied. Flow cytometry with combinations of monoclonal antibodies to B cell and T cell subsets was used.
The frequency and total number of CD19+ cells in the peripheral blood decreased a mean of 97% for more than 3 months in all but 1 patient following rituximab therapy. All B cell populations were depleted. More than 80% of residual B cells showed a memory or plasma cell precursor phenotype. B cell repopulation occurred a mean of 8 months after treatment and was dependent on the formation of naive B cells, which showed an increased expression of CD38 and CD5. During repopulation, increased numbers of circulating immature B cells, CD19+,IgD+,CD38high,CD10low,CD24high cells, were identified. Patients who experienced a relapse of RA on return of B cells tended to show repopulation with higher numbers of memory B cells. A small number of T cells and natural killer cells expressed low levels of CD20. These cells were depleted following rituximab therapy and returned to the circulation a mean of 5 months after treatment. No other significant changes were detected in the T cell populations studied.
Rituximab induced a profound depletion of all peripheral blood B cell populations in patients with RA. Repopulation occurred mainly with naive mature and immature B cells. Patients whose RA relapsed on return of B cells tended to show repopulation with higher numbers of memory B cells.