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. 2023 Jun;102(6):1421-1431.
doi: 10.1007/s00277-023-05204-7. Epub 2023 Apr 12.

Anti-CD20 antibodies and bendamustine attenuate humoral immunity to COVID-19 vaccination in patients with B-cell non-Hodgkin lymphoma

Takashi Ishio  1 , Shihori Tsukamoto  2 , Emi Yokoyama  2 , Koh Izumiyama  2 , Makoto Saito  2 , Haruna Muraki  3 , Mirei Kobayashi  2 , Akio Mori  2 , Masanobu Morioka  2 , Takeshi Kondo  2
Affiliations

Anti-CD20 antibodies and bendamustine attenuate humoral immunity to COVID-19 vaccination in patients with B-cell non-Hodgkin lymphoma

Takashi Ishio et al. Ann Hematol. 2023 Jun.

Abstract

Serologic responses of COVID-19 vaccine are impaired in patients with B-cell lymphoma, especially those who had recently been treated with anti-CD20 monoclonal antibodies. However, it is still unclear whether those patients develop an immune response following vaccination. We investigated the efficacy of vaccination against SARS-CoV-2 in 171 patients with B-cell non-Hodgkin lymphoma (B-NHL) who received two doses of an mRNA-based COVID-19 vaccine and we compared the efficacy of vaccination to that in 166 healthy controls. Antibody titers were measured 3 months after administration of the second vaccine dose. Patients with B-NHL showed a significantly lower seroconversion rate and a lower median antibody titer than those in healthy controls. The antibody titers showed correlations with the period from the last anti-CD20 antibody treatment to vaccination, the period from the last bendamustine treatment to vaccination and serum IgM level. The serologic response rates and median antibody titers were significantly different between diffuse large B-cell lymphoma (DLBCL) patients in whom anti-CD20 antibody treatment was completed within 9 months before vaccination and follicular lymphoma (FL) patients in whom anti-CD20 antibody treatment was completed within 15 months before vaccination. Moreover, the serologic response rates and median antibody titers were significantly different among FL patients in whom bendamustine treatment was completed within 33 months before vaccination. We demonstrated that B-NHL patients who were recently treated with anti-CD20 antibodies and bendamustine had a diminished humoral response to COVID-19 vaccination. UMIN 000,045,267.

Keywords: Anti-CD20 antibodies; B-cell non-Hodgkin lymphoma (B-NHL); Bendamustine; COVID-19 vaccine; SARS-CoV-2.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A Comparison of anti-SARS-CoV-2 S antibody titers between healthy controls and B-NHL patients. B, C Anti-SARS-CoV-2 S antibody titers in patients with B-NHL divided by B vaccine subtypes and C treatment status. HC, healthy controls; B-NHL, B-cell non-Hodgkin lymphoma
Fig. 2
Fig. 2
Correlations of anti-SARS-CoV-2 S antibody titers with A the period from the last anti-CD20 antibody treatment to vaccination, B the period from the last bendamustine treatment to vaccination and C serum IgM level
Fig. 3
Fig. 3
A Anti-SARS-CoV-2 S antibody titers in B-NHL patients divided by previous therapy with anti-CD20 antibody. B Scatter plot of the period from the last anti-CD20 antibody treatment to vaccination and anti-SARS-CoV-2 S antibody titers in patients with DLBCL. C Comparison of anti-SARS-CoV-2 S antibody titers between DLBCL patients who completed anti-CD20 antibody treatment within 9 months before vaccination and those who completed the treatment more than 9 months before vaccination. D Scatter plot of the period from the last anti-CD20 antibody treatment to vaccination and anti-SARS-CoV-2 S antibody titers in patients with FL. E Comparison of anti-SARS-CoV-2 S antibody titers between FL patients who received the last anti-CD20 antibody treatment within 15 months prior to vaccination and those who received the treatment more than 15 months prior to vaccination
Fig. 4
Fig. 4
A, B Anti-SARS-CoV-2 S antibody titers in FL patients divided by previous therapy with bendamustine in A the entire cohort and B the cohort of patients who completed anti-CD20 antibody treatment more than 15 months before vaccination. C Scatter plot of the period from the last bendamustine treatment to vaccination and anti-SARS-CoV-2 S antibody titers in patients with FL. D Comparison of anti-SARS-CoV-2 S antibody titers between FL patients who completed bendamustine treatment within 33 months before vaccination and those who completed the treatment more than 33 months before vaccination
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References

    1. Mehta V, Goel S, Kabarriti R, Cole D, Goldfinger M, Acuna-Villaorduna A, Pradhan K, Thota R, Reissman S, Sparano JA, Gartrell BA, Smith RV, Ohri N, Garg M, Racine AD, Kalnicki S, Perez-Soler R, Halmos B, Verma A. Case fatality rate of cancer patients with COVID-19 in a New York hospital system. Cancer Discov. 2020;10(7):935–941. doi: 10.1158/2159-8290.CD-20-0516. - DOI - PMC - PubMed
    1. Lee LYW, Cazier JB, Starkey T, Briggs SEW, Arnold R, Bisht V, Booth S, Campton NA, Cheng VWT, Collins G, Curley HM, Earwaker P, Fittall MW, Gennatas S, Goel A, Hartley S, Hughes DJ, Kerr D, Lee AJX, Lee RJ, Lee SM, McKenzie H, Middleton CP, Murugaesu N, Newsom-Davis T, Olsson-Brown AC, Palles C, Powles T, Protheroe EA, Purshouse K, Sharma-Oates A, Sivakumar S, Smith AJ, Topping O, Turnbull CD, Varnai C, Briggs ADM, Middleton G, Kerr R, Team UKCCMP COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study. Lancet Oncol. 2020;21(10):1309–1316. doi: 10.1016/S1470-2045(20)30442-3. - DOI - PMC - PubMed
    1. Vijenthira A, Gong IY, Fox TA, Booth S, Cook G, Fattizzo B, Martin-Moro F, Razanamahery J, Riches JC, Zwicker J, Patell R, Vekemans MC, Scarfo L, Chatzikonstantinou T, Yildiz H, Lattenist R, Mantzaris I, Wood WA, Hicks LK. Outcomes of patients with hematologic malignancies and COVID-19: a systematic review and meta-analysis of 3377 patients. Blood. 2020;136(25):2881–2892. doi: 10.1182/blood.2020008824. - DOI - PMC - PubMed
    1. Passamonti F, Cattaneo C, Arcaini L, Bruna R, Cavo M, Merli F, Angelucci E, Krampera M, Cairoli R, Della Porta MG, Fracchiolla N, Ladetto M, Gambacorti Passerini C, Salvini M, Marchetti M, Lemoli R, Molteni A, Busca A, Cuneo A, Romano A, Giuliani N, Galimberti S, Corso A, Morotti A, Falini B, Billio A, Gherlinzoni F, Visani G, Tisi MC, Tafuri A, Tosi P, Lanza F, Massaia M, Turrini M, Ferrara F, Gurrieri C, Vallisa D, Martelli M, Derenzini E, Guarini A, Conconi A, Cuccaro A, Cudillo L, Russo D, Ciambelli F, Scattolin AM, Luppi M, Selleri C, Ortu La Barbera E, Ferrandina C, Di Renzo N, Olivieri A, Bocchia M, Gentile M, Marchesi F, Musto P, Federici AB, Candoni A, Venditti A, Fava C, Pinto A, Galieni P, Rigacci L, Armiento D, Pane F, Oberti M, Zappasodi P, Visco C, Franchi M, Grossi PA, Bertu L, Corrao G, Pagano L, Corradini P, Investigators I-H-C. Clinical characteristics and risk factors associated with COVID-19 severity in patients with haematological malignancies in Italy: a retrospective, multicentre, cohort study. Lancet Haematol. 2020;7(10):e737–e745. doi: 10.1016/S2352-3026(20)30251-9. - DOI - PMC - PubMed
    1. Wood WA, Neuberg DS, Thompson JC, Tallman MS, Sekeres MA, Sehn LH, Anderson KC, Goldberg AD, Pennell NA, Niemeyer CM, Tucker E, Hewitt K, Plovnick RM, Hicks LK. Outcomes of patients with hematologic malignancies and COVID-19: a report from the ASH Research Collaborative Data Hub. Blood Adv. 2020;4(23):5966–5975. doi: 10.1182/bloodadvances.2020003170. - DOI - PMC - PubMed

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