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. 2025 Jul;31(8):1007-1010.
doi: 10.1177/13524585251330962. Epub 2025 Apr 1.

Home-sampling of B cells using quantitative dried blood spots to enable tailored therapeutic re-dosing of anti-CD20 therapies

Emma C Tallantyre  1   2 , Emily Jacob  3 , Laura Davies  2 , Samantha Loveless  1 , Emily Carne  3 , Kath Bramhall  3 , Janika Schulze  4 , Stuart J Moat  5   6 , Stephen Jolles  3   6
Affiliations

Home-sampling of B cells using quantitative dried blood spots to enable tailored therapeutic re-dosing of anti-CD20 therapies

Emma C Tallantyre et al. Mult Scler. 2025 Jul.

Abstract

Anti-CD20 monoclonal antibodies are commonly used to manage neuroinflammatory diseases. The rate of B-cell re-emergence after dosing of ocrelizumab or rituximab varies considerably between individuals, but most people remain completely B-cell depleted at 6 months. Tailoring the dosing according to B-cell re-emergence may improve the safety profile of anti-CD20s but poses logistical challenges such as the need for regular attendances for whole-blood sampling. Here we combined a quantitative dried blood spot sampling technique with a DNA methylation test, to provide a reliable means of remotely monitoring B-cell counts, with 100% sensitivity and specificity for reaching >10 × 106 cells/L.

Keywords: Multiple sclerosis; disease-modifying therapies; immunology; neuromyelitis optica (NMO); treatment response.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: In the last 5 years, E.T. has received honorarium for consulting work from Biogen, Janssen, Merck, Novartis, and Roche. She has received travel grants to attend or speak at educational meetings from Biogen, Merck, Neuroax, Roche, and Novartis. SJ has received support for conferences, speaker, advisory boards, trials, data and safety monitoring boards, studies and projects with CSL Behring, Takeda, Octapharma, Grifols, BPL, LFB, Kedrion, Pharming, Biocryst, Capitainer, Swedish Orphan Biovitrum, Biotest, Binding Site, GSK, Sanofi, UCB Pharma and HCRW. E.M.C. has received support for conferences, speaker, and advisory boards with CSL Behring, Takeda, Octapharma, Grifols, BPL, LFB, Biocryst, Kalvista and Novartis. J.S. receives salary from Epimmune diagnostics, who performed detection of cells in DBS samples. S.J.M., E.J. and K.B. reports no conflicts of interest.

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