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Multicenter Study
. 2024 Feb;13(3):e6997.
doi: 10.1002/cam4.6997.

An international multicenter study comparing COVID-19 omicron outcomes in patients with hematological malignancies treated with obinutuzumab versus rituximab

Tali Shafat  1   2   3   4 , Daniel Grupel  5   6 , Tzvika Porges  7 , Ran Abuhasira  2 , Ana Belkin  8   9 , Ofir Deri  10 , Yonatan Oster  5   6 , Shadi Zahran  5   6 , Ehud Horwitz  5   6 , Netanel A Horowitz  11 , Hazim Khatib  11 , Marjorie Vieira Batista  4   12 , Anita Cassoli Cortez  13 , Tal Brosh-Nissimov  14   15 , Yafit Segman  15   16 , Linor Ishay  17   18 , Regev Cohen  17   18 , Alaa Atamna  4   19 , Amy Spallone  3   4 , Roy F Chemaly  3   4 , Juan Carlos Ramos-Ramos  4   20 , Michal Chowers  21   22 , Evgeny Rogozin  23 , Noga Carmi Oren  23 , Şiran Keske  4   24 , Orit Wolfovitz Barchad  25 , Lior Nesher  1   4 ; European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV)
Affiliations
Multicenter Study

An international multicenter study comparing COVID-19 omicron outcomes in patients with hematological malignancies treated with obinutuzumab versus rituximab

Tali Shafat et al. Cancer Med. 2024 Feb.

Abstract

Objectives: Hematological malignancy (HM) patients treated with anti-CD20 monoclonal antibodies are at higher risk for severe COVID-19. A previous single-center study showed worse outcomes in patients treated with obinutuzumab compared to rituximab. We examined this hypothesis in a large international multicenter cohort.

Methods: We included HM patients from 15 centers, from five countries treated with anti-CD20, comparing those treated with obinutuzumab (O-G) to rituximab (R-G) between December 2021 and June 2022, when Omicron lineage was dominant.

Results: We collected data on 1048 patients. Within the R-G (n = 762, 73%), 191 (25%) contracted COVID-19 compared to 103 (36%) in the O-G. COVID-19 patients in the O-G were younger (61 ± 11.7 vs. 64 ± 14.5, p = 0.039), had more indolent HM diagnosis (aggressive lymphoma: 3.9% vs. 67.0%, p < 0.001), and most were on maintenance therapy at COVID-19 diagnosis (63.0% vs. 16.8%, p < 0.001). Severe-critical COVID-19 occurred in 31.1% of patients in the O-G and 22.5% in the R-G. In multivariable analysis, O-G had a 2.08-fold increased risk for severe-critical COVID-19 compared to R-G (95% CI 1.13-3.84), adjusted for Charlson comorbidity index, sex, and tixagevimab/cilgavimab (T-C) prophylaxis. Further analysis comparing O-G to R-G demonstrated increased hospitalizations (51.5% vs. 35.6% p = 0.008), ICU admissions (12.6% vs. 5.8%, p = 0.042), but the nonsignificant difference in COVID-19-related mortality (n = 10, 9.7% vs. n = 12, 6.3%, p = 0.293).

Conclusions: Despite younger age and a more indolent HM diagnosis, patients receiving obinutuzumab had more severe COVID-19 outcomes than those receiving rituximab. Our findings underscore the need to evaluate the risk-benefit balance when considering obinutuzumab therapy for HM patients during respiratory viral outbreaks.

Keywords: COVID-19; anti-CD20 monoclonal antibodies; hematological malignancies; obinutuzumab; rituximab.

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Conflict of interest statement

The authors declare that they have no conflicts of interest with respect to this study. This study did not receive funding support.

Figures

FIGURE 1
FIGURE 1
Flowchart of the study population.
See this image and copyright information in PMC

References

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