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- Title
Impact of Treatment with Anti-CD20 Monoclonal Antibody on the Production of Neutralizing Antibody Against Anti–SARS-CoV-2 Vaccination in Mature B-Cell Neoplasms.
- Authors
Onishi, Akio; Matsumura-Kimoto, Yayoi; Mizutani, Shinsuke; Tsukamoto, Taku; Fujino, Takahiro; Miyashita, Akihiro; Nishiyama, Daichi; Shimura, Kazuho; Kaneko, Hiroto; Kawata, Eri; Takahashi, Ryoichi; Kobayashi, Tsutomu; Uchiyama, Hitoji; Uoshima, Nobuhiko; Nukui, Yoko; Shimura, Yuji; Inaba, Tohru; Kuroda, Junya
- Abstract
Background and Purpose: Anti-CD20 monoclonal antibodies (MoAbs), rituximab (RIT), and obinutuzumab (OBZ) are the central components of immunochemotherapy for B-cell lymphoma (BCL). However, these agents potentially cause B-cell depletion, resulting in the impairment of antibody (Ab) production. During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the optimal prediction of Ab response against anti–SARS-CoV-2 vaccination is critically important in patients with BCL treated by B-cell depletion therapeutics to prevent coronavirus disease 2019 (COVID-19). Patients and Methods: We investigated the effect of using RIT and/or OBZ on the Ab response in 131 patients with various types of BCL who received the second SARS-CoV-2 mRNA vaccine either after, during, or before immunochemotherapy containing B-cell–depleting moiety between June and November 2021 at seven institutes belonging to the Kyoto Clinical Hematology Study Group. The SARS-Cov-2 neutralizing Ab (nAb) was measured from 14 to 207 days after the second vaccination dose using the iFlash3000 automatic analyzer and the iFlash-2019-nCoV Nab kit. Results: Among 86 patients who received the vaccine within 12 months after B-cell depletion therapy, 8 (9.3%) were seropositive. In 30 patients who received the vaccine after 12 months from B-cell depletion therapy, 22 (73%) were seropositive. In 15 patients who were subjected to B-cell depletion therapy after vaccination, 2 (13%) were seropositive. The multivariate analysis indicated that an interval of 12 months between B-cell depletion therapy and the subsequent vaccination was significantly associated with effective Ab production. Receiver operating characteristic curve analysis identified the optimal threshold period after anti-CD20 MoAb treatment, which determines the seropositivity against SARS-CoV-2, to be 342 days. Conclusion: The use of anti-CD20 MoAb within 12 months before vaccination is a critical risk for poor Ab response against anti–SARS-CoV-2 vaccination in patients with BCL.
- Subjects
B cells; SARS-CoV-2; ANTIBODY formation; MONOCLONAL antibodies; B cell receptors; COVID-19; RECEIVER operating characteristic curves
- Publication
Infection & Drug Resistance, 2023, Vol 16, p509
- ISSN
1178-6973
- Publication type
Article
- DOI
10.2147/IDR.S396271