Cellular Immunity Profile in B-Cell Non-Hodgkin Lymphoma Patients Receiving Rituximab-Based Chemotherapy

Area of Science:

• Immunology
• Oncology
• Hematology

Background:

• Rituximab-based chemotherapy improves outcomes in B-cell non-Hodgkin lymphoma (NHL).
• However, it may increase the risk of opportunistic infections due to exacerbated immunosuppression.
• Infection prophylaxis is not routinely implemented in Indonesia.

Purpose of the Study:

• To characterize cellular immunity changes in patients undergoing rituximab-based chemotherapy.
• To compare these changes with those in patients receiving non-rituximab chemotherapy.
• To provide immunological evidence for guiding prophylaxis strategies in NHL.

Main Methods:

• Prospective cohort study involving adult patients with biopsy-confirmed B-cell NHL.
• Patients were divided into rituximab-containing or non-rituximab chemotherapy groups.
• Absolute lymphocyte, CD4, and CD8 counts were measured pre-treatment and post-third cycle.

Main Results:

• Rituximab group showed significantly lower absolute CD4 count and CD4/CD8 ratio post-chemotherapy compared to controls.
• The rituximab group experienced greater reductions in absolute lymphocyte, CD4, and CD8 counts.
• Chemotherapy without rituximab led to decreases in lymphocyte and CD8 counts, with CD4 counts largely preserved.

Conclusions:

• Rituximab-based chemotherapy is associated with greater cellular immunity suppression than chemotherapy alone.
• Significant CD4 depletion and reduced CD4/CD8 ratio were observed with rituximab.
• Findings support routine immune monitoring and inform prophylaxis strategies for rituximab-treated NHL patients.