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VDJ-Seq: Deep Sequencing Analysis of Rearranged Immunoglobulin Heavy Chain Gene to Reveal Clonal Evolution Patterns of B Cell Lymphoma
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Cytomegalovirus Occurrence and Time-to-onset Analysis Under Bendamustine With Anti-CD20 Antibodies Using the JADER

Kaori Ito1,2,3, Takenao Koseki2, Misaki Morisaku2

  • 1Faculty of Pharmacy, Meijo University, Nagoya, Japan; itoka@meijo-u.ac.jp.

In Vivo (Athens, Greece)
|February 28, 2024
PubMed
Summary

Bendamustine combination therapies with rituximab or obinutuzumab may increase cytomegalovirus (CMV) infection duration in lymphoma patients. Further research into cell-mediated immunity is recommended post-treatment.

Keywords:
BendamustineJapanese Adverse Drug Event Report databaseanti-CD20 monoclonal antibodiescytomegalovirus infection

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Area of Science:

  • Oncology
  • Immunology
  • Pharmacovigilance

Background:

  • Patients with malignant lymphoma have weakened immune function, increasing risk of chemotherapy-induced immunosuppression and cytomegalovirus (CMV) infection.
  • Concomitant therapy with bendamustine and rituximab or obinutuzumab intensifies immunosuppression, potentially affecting CMV onset.

Purpose of the Study:

  • To assess differences in CMV onset between bendamustine monotherapy and combination therapy with rituximab or obinutuzumab.
  • Utilize the Japanese Adverse Drug Event Report database (JADER) for analysis.

Main Methods:

  • Analyzed JADER data from April 2004 to September 2022.
  • Defined CMV infection using MedDRA preferred terms.
  • Calculated Reporting Odds Ratios (ROR) for CMV signals for bendamustine monotherapy, rituximab, obinutuzumab, bendamustine+rituximab (BR), and bendamustine+obinutuzumab (GB).

Main Results:

  • CMV signals were confirmed for both monotherapy and combination therapies.
  • Median CMV infection durations were 41.0 days for bendamustine monotherapy, 63.5 days for BR, and 61.0 days for GB.
  • Some cases of CMV infection exceeded 200 days.

Conclusions:

  • JADER analysis identified significant CMV signals associated with rituximab, obinutuzumab, and bendamustine.
  • Caution is advised regarding potential CMV reactivation 7-9 months post-bendamustine administration.
  • Further investigation into cell-mediated immunity suppression is warranted.