Prolonged B-cell depletion following rituximab therapy in systemic lupus erythematosus: a report of two cases
1 Centre for Rheumatology Research, University College of London, London, UK
2 Department of Rheumatology, Karolinska University Hospital, Stockholm, Sweden
Correspondence to:
Professor D A Isenberg, Centre for Rheumatology, Room 331, 3rd floor, Windeyer Building, University College London, 46 Cleveland Street, London W1T 4JF, UK; d.isenberg@ucl.ac.uk
Accepted 22 March 2008
| The first 150 words of the full text of this article appear below. |
Rituximab, a chimeric monoclonal antibody against the B-lymphocyte marker CD 20, has been previously used in open studies in the treatment of patients with systemic lupus erythematosus (SLE), with some success.1 2 Its therapeutic effect is attributed to the profound depletion of native and autoimmune B cells. The initial period of depletion has been reported to last for about 6 months, followed by a repopulation of peripheral B cells 9–12 months after treatment in most cases. We report two cases of prolonged B-cell depletion of 7 and 5 years duration, respectively, after a single course of rituximab treatment in two patients with SLE.
A 42-year-old woman with anti-SSA and anti-RNP positive SLE was initially referred to the Centre for Rheumatology Research, University College of London in 1995 for management of persistent fatigue, polyarthritis, Raynauds phenomenon and pleurisy. Despite treatment with various immunosuppressive agents, her disease remained clinically and serologically active (
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