Effects of Low-Dose Rituximab Therapy in Patients With Primary Cytomegalovirus Infection

Objectives: Cytomegalovirus infection is an im portant cause of morbidity and mortality among recipients undergoing hematopoietic stem cell and solid-organ transplant. The risk of cytomegalovirus infection is high in cytomegalovirus-seronegative recipients of cytomegalovirus-seropositive organs (donor positive/recipient negative) and recipients with strong immunosuppressive status such as those receiving rituximab induction or antirejection treatment. However, it remains unclear how rituximab affects patients with primary cyto megalovirus infection. We evaluated the effects of low-dose rituximab therapy on clinical and immunologic outcomes in recipients who were donor positive but recipient negative for primary cytomegalovirus infections. Materials and Methods: We conducted a retro spective review of patients with primary cyto megalovirus infections from January 2005 to March 2014. Patient outcomes were compared between groups administered given rituximab or given no intervention at the time of transplant. Results: Our study group included 49 recipients with primary cytomegalovirus infection, including 32 who received rituximab therapy (group 1) and 17 who did not (group 2). No significant differences were observed between groups in the duration of cytomegalovirus seroconversion (P=.0570) and initial cytomegalovirus immunoglobulin G titers (P=.8418). Conclusions: Rituximab induction therapy does not affect clinical or immunologic outcomes of primary cytomegalovirus infection, even in high- risk recipients who are donor positive but recipient negative for primary cytomegalovirus infections.