Response to rituximab in patients with type II cryoglobulinemia

Alan H Bryce, Angela Dispenzieri, Robert A. Kyle, Martha Lacy, S Vincent Rajkumar, David J. Inwards, Christopher A. Yasenchak, Shaji K Kumar, Morie Gertz

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Type II cryoglobulinemia (CG) is a heterogeneous, generally indolent disorder caused by a monoclonal antibody with activity against polyclonal antibodies and is commonly associated with hepatitis C, lymphoproliferative disorders (LPDs), or autoimmune diseases. It can lead to substantial morbidity, including renal failure, cutaneous ulcers, or neuropathy. Medical records were reviewed for 8 patients with previously treated symptomatic CG who were part of a prospectively held dysproteinemia database. Patients subsequently received 14 total courses of rituximab treatment (standard infusion, 375 mg/m2 for 4 or 8 doses) between February 1999 and March 2005. One patient had essential CG, and 1 had Gaucher disease with hypersplenism. Six patients had an LPD, and 4 of them had concomitant disorders (2 with hepatitis C and 2 with Sjögren syndrome). Treatment indications included purpura, LPD, cutaneous ulcers, and renal failure. Clinical improvement was evaluated by improved cryocrit, total complement, C4, and rheumatoid factor. Six patients had some clinical improvement. Cutaneous manifestations were the most responsive; renal disease and lymphoma were more refractory. Laboratory values showed improvement after 7 of 12 available treatment courses. No adverse reactions were noted. Overall, rituximab appears to be a safe and effective therapy.

Original languageEnglish (US)
Pages (from-to)140-144
Number of pages5
JournalClinical Lymphoma and Myeloma
Volume7
Issue number2
StatePublished - Sep 2006

Fingerprint

Cryoglobulinemia
Lymphoproliferative Disorders
Skin Ulcer
Hepatitis C
Renal Insufficiency
Hypersplenism
Complement C4
Skin Manifestations
Gaucher Disease
Purpura
Rheumatoid Factor
Therapeutics
Autoimmune Diseases
Medical Records
Lymphoma
Monoclonal Antibodies
Rituximab
Databases
Morbidity
Kidney

Keywords

  • Cryoglubulins
  • Lymphoproliferative disorders
  • Sjögren syndrome
  • Waldenström's macroglobulinemia

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Hematology

Cite this

Response to rituximab in patients with type II cryoglobulinemia. / Bryce, Alan H; Dispenzieri, Angela; Kyle, Robert A.; Lacy, Martha; Rajkumar, S Vincent; Inwards, David J.; Yasenchak, Christopher A.; Kumar, Shaji K; Gertz, Morie.

In: Clinical Lymphoma and Myeloma, Vol. 7, No. 2, 09.2006, p. 140-144.

Research output: Contribution to journalArticle

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