ORIGINAL ARTICLE Rituximab therapy increased post-transplant cytomegalovirus complications in Non-Hodgkin’ s lymphoma patients receiving autologous hematopoietic stem cell transplantation Ming-Yang Lee & Tzeon-Jye Chiou & Liang-Tsai Hsiao & Muh-Hwa Yang & Pang-Chan Lin & Say-Bee Poh & Chueh-Chuan Yen & Jin-Hwang Liu & Hao-Wei Teng & Ta-Chung Chao & Wei-Shu Wang & Po-Min Chen Received: 16 January 2007 / Accepted: 25 September 2007 / Published online: 18 October 2007 # Springer-Verlag 2007 Abstract The use of monoclonal antibody, rituximab, had been reported to be associated with some severe viral in- fections. The inference of rituximab therapy and post- transplant cytomegalovirus (CMV) infectious complications in non-Hodgkin’ s lymphoma (NHL) patients is still unclear now. From 2002 to 2005, 46 patients with relapsed indolent or high-risk aggressive B cell NHL who received rituximab (17 patients) or not (29 patients) before autologous hematological stem cell transplantation (HSCT) in one institute were retrospectively analyzed for the risk factors of CMV compli- cations after transplantation. Pre-transplant and post-transplant CMV infectious conditions, conditioning regimens, transplant types, and post-transplant complications were recorded. Post- transplant infectious complications were followed up until 6 months after transplantation.Seventeen of 46 patients received rituximab before HSCT. Three of them suffered from CMV infection and two of them developed CMV disease. All of the patients with CMV disease recovered after ganciclovir and CMV-specific immunoglobulin therapy. Twenty-nine of 46 patients without rituximab treatment before HSCT did not have CMV complications after HSCT. The risks to develop CMV infections after autologous HSCT were higher in rituximab-treated patients (17.6% vs 0%, p =0.045, Fisher exact test, two-sided). The risks to develop CMV diseases had higher trend with rituximab therapy than without rituximab therapy (11.7% vs 0%, p =0.131, Fisher exact test, two-sided). The NHL patients receiving rituximab therapy had higher risk to develop CMV infectious complications after autologous HSCT. Keywords Cytomegalovirus infection . Rituximab therapy . Hematopoietic stem cell transplantation . Lymphoma Introduction High-dose chemotherapy with stem cell rescue may effectively eliminate residual disease, reduced the risk of relapse, and prolonged disease-free survival in non-Hodgkin’ s lymphoma (NHL) [1–4]. Monoclonal antibody, such as rituximab (Mabthera®; Roche Pharma AG, Switzerland) therapy alone, or combined with chemotherapy had been proved to be Ann Hematol (2008) 87:285–289 DOI 10.1007/s00277-007-0397-0 M.-Y. Lee Division of Hemato-Oncology, Department of Medicine, Chia-Yi Christian Hospital, Chia-Yi, Taiwan, Republic of China M.-Y. Lee : T.-J. Chiou : L.-T. Hsiao : M.-H. Yang : P.-C. Lin : C.-C. Yen : J.-H. Liu : H.-W. Teng : T.-C. Chao : W.-S. Wang : P.-M. Chen National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China T.-J. Chiou : L.-T. Hsiao : M.-H. Yang : P.-C. Lin : C.-C. Yen : J.-H. Liu : H.-W. Teng : T.-C. Chao : W.-S. Wang : P.-M. Chen Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No.201, Sec. 2, Shih-Pai Road, Taipei, Taiwan 112, Republic of China S.-B. Poh Division of Medical Oncology, Department of Medicine, Ping-Tung Christian Hospital, Ping Tung, Taiwan, Republic of China T.-J. Chiou (*) Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan 112, Republic of China e-mail: tjchiou@vghtpe.gov.tw