Characteristics of patients who developed late-onset neutropenia.
| Characteristic | Case | ||||
|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | |
| Age at first treatment with RTX, yrs | 63 | 25 | 62 | 51 | 55 |
| Sex | F | F | F | M | F |
| Disease duration at first treatment with RTX, yrs | 18 | 10 | 14 | 24 | 19 |
| Concomitant DMARD | None | None | MMF (1 g BD) | MTX (15 mg) | MTX (25 mg) |
| Number of previous DMARD (including the current) | 5 | 5 | 5 | 6 | 4 |
| Number of previous biologics | 1 | 3 | 1 | 2* | 2 |
| Oral prednisolone at the time of neutropenia | No | No | 7.5 mg | 5 mg | 7.5 mg |
| Duration between last cycle and start of neutropenic episode, days | 168 | 71,106 | 151 | 184 | 135 |
| Number of RTX cycles before neutropenia | 1 | 7 | 3 | 1 | 1 |
| ANC nadir (× 109 /l) | 0 | 1.1, 0 | 0 | 0.4 | 1.3 |
| Duration of neutropenia, days | 9 | 14, 4 | 7 | 15 | 14 |
| IgG (6–16 g/l) | 6.7** | 8*** | 7.4 | N/A | N/A |
| IgM (0.5–2 g/l) | 0.52** | 0.73*** | 2.45 | N/A | N/A |
| IgA (0.8–4 g/l) | 1** | 2.47*** | 1.54 | N/A | N/A |
| CD19 (× 109/l) | 0** | 0*** | N/A | N/A | N/A |
| G-CSF | No | Yes | Yes | No | No |
| Complications | Pneumonia | No | Pneumonia | No | No |
↵* One TNF-α inhibitor and alemtuzumab.
↵** Two weeks after the neutropenic episode.
↵*** Five weeks after the neutropenic episode. TNF: tumor necrosis factor; RTX: rituximab; DMARD: disease-modifying antirheumatic drugs; MMF: mycophenolate mofetil; MTX: methotrexate; ANC: absolute neutrophil count; Ig: immunoglobulin; G-CSF: granulocyte colony stimulating factor; N/A: not available.