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Blood, Vol. 96 No. 3 (August 1), 2000:
pp. 1184-1186
BRIEF REPORT
Pure red cell aplasia due to parvovirus B19 in a patient treated
with rituximab
Vivek R. Sharma,
Donald R. Fleming, and
Stephen P. Slone
From the Division of Medical Oncology/Hematology, the
Department of Pathology, and the James Graham Brown Cancer Center,
University of Louisville, Louisville, KY.
Rituximab is a chimeric monoclonal antibody directed
against CD20 and used in the treatment of B-cell non-Hodgkin's
lymphoma. Due to its ability to deplete B lymphocytes, rituximab can
interfere with humoral immunity, causing it to be suppressed for
several months after treatment. The reported case depicts a serious
consequence of this effect of rituximab therapy: pure red cell aplasia
resulting from chronic parvovirus B19 infection. The point of interest
in this case is not only the association between rituximab therapy and
pure red cell aplasia, but the diagnostic and therapeutic utility of
the knowledge of parvovirus B19 as the likely etiologic link between
the two. Given the known efficacy of intravenous immunoglobulin (IVIg)
in the treatment of chronic parvovirus B19 infection, this therapy
can cure some of these patients and successfully render most others
transfusion-independent until recovery of their own humoral immune system.

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