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Re: flu vaccine while doing Rituxan

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Rituximab works by binding to antibody receptors on T cell and NK cells, as well

as activating complement. All of these might be non-specifically activated by

IV Ig. The antibodies in IV Ig are sometimes " turned on " unnecessarily and then

will bind these receptors or activate complement. Since the IV Ig is just

prophylactic, I always defer it during rituximab treatment.

Rick Furman, MD

>

> I am wondering if a flu shot while doing a four week Rituxan cycle

> would either be pretty ineffective or even dangerous. I'm guessing

> the R would knock out most of the B's that could respond to the

> vaccine. I wish I understood how all this works!

>

> Also, Dr. Furman, I am remembering your cautioning against doing IVIG

> within 2 weeks of Rituxan therapy because it interferes with the R.

> My doctor doesn't understand this and I would like to explain your

> reasoning because it seems commonsensical to me. But I can't give him

> reasons why. Thanks for all your continued generosity on this list

> and in practice! Carol

>

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