The late adverse events of rituximab therapy - Rare but there!

Ron Ram, Isaac Ben-Bassat, Ofer Shpilberg, Aaron Polliack, Pia Raanani

Research output: Contribution to journalReview articlepeer-review

118 Scopus citations


Rituximab, an anti CD20 monoclonal antibody, has now become a cornerstone in the treatment of many CD20 positive hematological malignancies and a variety of autoimmune disorders. In contrast to the acute allergic and cytokine associated reactions, late adverse events of rituximab are indeed uncommon but at the same time probably under-reported. In this review, we detail late adverse events reported since its use in hemato-oncological neoplasias and other disorders. These adverse events include the development of late-onset neutropenia, defects of immune reconstitution with associated immune compromise, infections, progressive multifocal leukoencephalopathy, reactivation of hepatitis, intestinal perforation and interstitial pneumonitis. Possible mechanisms involved in rituximab-associated complications and the pathogenesis of these adverse effects are reviewed and discussed. Evidence based graded recommendations for the management of these adverse effects are proposed.

Original languageEnglish
Pages (from-to)1083-1095
Number of pages13
JournalLeukemia and Lymphoma
Issue number7
StatePublished - 2009
Externally publishedYes


  • Antibody-based immunotherapy
  • Immunotherapy
  • Lymphoma and Hodgkin lymphoma


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