Persistent COVID-19 Pneumonia and Failure to Develop Anti-SARS-CoV-2 Antibodies During Rituximab Maintenance Therapy for Follicular Lymphoma

Yasuda, Hajime; Tsukune, Yutaka; Watanabe, Naoki; Sugimoto, Kazuya; Uchimura, Ayana; Tateyama, Misa; Miyashita, Yosuke; Ochi, Yusuke; Komatsu, Norio

doi:10.1016/j.clml.2020.08.017

Cited by 77 publications

(76 citation statements)

References 6 publications

(8 reference statements)

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“…Studies comparing seroconversion in patients with cancer versus controls, report seroconversion rates ranging from 72.5% 16 (retrospective) to 87.9 % (prospective) 17 . A similar finding in an anti-CD20-treated patient was noted in a recently published case report 18 . In our study, we observed significant and clinically meaningful differences in seroconversion rates in patients who had received anti-CD20 therapy and stem cell transplants.…”

Section: Discussionsupporting

confidence: 88%

Patterns of seroconversion for SARS-CoV-2 IgG in patients with malignant disease and association with anticancer therapy

et al. 2021

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Patients with cancer have been identified in several studies to be at high risk of developing severe COVID-19; however, rates of SARS-CoV-2 IgG seroconversion and its association with cancer types and anticancer therapy remain obscure. We conducted a retrospective cohort study in patients with cancer who underwent SARS-CoV-2 IgG testing. Two hundred and sixty-one patients with a cancer diagnosis underwent SARS-CoV-2 IgG testing and demonstrated a high rate of seroconversion (92%). However, significantly lower seroconversion was observed in patients with hematological malignancies (82%), patients who received anti-CD-20 antibody therapy (59%) and stem cell transplant (60%). Notably, all 17 patients who received immunotherapy, including 16 that received anti-PD-1/PD-L1 monoclonal antibodies, developed SARS-CoV-2 IgG antibodies (100% seroconversion). These data show differential rates of seroconversion in specific patient groups and bear importance for clinical monitoring and vaccination strategies that are being developed to mitigate the COVID-19 pandemic.

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Section: Discussionsupporting

confidence: 88%

Patterns of seroconversion for SARS-CoV-2 IgG in patients with malignant disease and association with anticancer therapy

et al. 2021

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“…This process is probably largely involved in cases of a prolonged and/or atypical course of COVID-19 characterised by a negative or delayed serological response against SARS-CoV-2 in B cell depleted patients. [12][13][14][15] It is of note however that many, non-serious, cases of COVID-19 in patients under treatment with RTX have been reported as well. 16 17 Until further studies will help us to understand the risk with respect to COVID-19 severity, treatment with biological diseasemodifying drugs, such as RTX, will have to be applied with particular caution in patients with rheumatic or auto-immune disease, especially if they suffer from other comorbidities which render them particularly at risk.…”

mentioning

confidence: 99%

Response to: ‘Antirheumatic drugs, B cell depletion and critical COVID-19: correspondence on ‘Clinical course of coronavirus disease 2019 (COVID-19) in a series of 17 patients with systemic lupus erythematosus under long-term treatment with hydroxychloroquine by Mathianet al’ by Notzet al

Mathian

Amoura

2020

Ann Rheum Dis

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Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research. Patient consent for publication Not required. Provenance and peer review Commissioned; internally peer reviewed. This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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“…It would be fortunate to predict even earlier these adverse cases, possible at the time of diagnosis. Therefore, these patients could get more aggressive treatment or vice versa: should the good prognostic group get more "permissive" therapy e.g., leaving maintenance therapy at the time of ongoing COVID pandemic and thus moderating B cell depletion [25] or just because the patient requires continuous granulocyte colony stimulating factor support?…”

Section: Discussionmentioning

confidence: 99%

“…When we combine all staging-, interim SUVmax and Ly/Mo ratio we cannot further improve PFS (p<0.0001, HR: 0.08303, 95%CI: 0.02492-0.2766, median PFS: 32 months vs. not met, 5-year PFS: 82.31 vs. 25…”

Section: 16%) Figurementioning

confidence: 97%

Clinical and Biological Prognostic Factors in Follicular Lymphoma Patients During Treatment

Jóna

Kenyeres

Barna³

et al. 2021

Preprint

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Introduction: Follicular lymphoma (FL) is an indolent yet heterogeneous B-cell lymphoproliferative disorder. Most people respond to treatment well. However, a particular group of patients has a poor prognosis, and these patients are difficult to define.Patients and methods: We retrospectively analyzed FL patients treated at the University of Debrecen in the past 20 years. We investigated prognostic factors that may influence the survival of FL patients.Results: We found a standardized uptake value (SUV)max cut-off value of 9.85 at the staging PET/CT to significantly separate FL patients’ progression-free survival (PFS) (p=0.0003, HR: 0.2560, 95%CI: 0.1232-0.5318). Lymphocyte/ monocyte (Ly/Mo) ratio of 3.45 drawn at diagnosis also significantly predicted PFS (p=0.0324, HR: 1.806, 95% CI: 1.051-3.104). Combining patients’ with staging SUVmax >9.85 and Ly/Mo < 3.45 a high-risk group of FL patients can be identified (p<0.0001, HR: 0.1033, 95%CI: 0.03719-0.2868). Similarly, a significant difference was shown with a SUVmax cut-off of 3.15 at the interim PET/CT (p<0.0001, HR: 0.1535, 95%CI: 0.06329-0.3720). Combining patients with staging SUVmax >9.85 and interim SUVmax >3.15, a high-risk group of FL patients can be identified (p<0.0001, HR: 0.1037, 95%CI: 0.03811-0.2824). The PFS difference is translated into overall survival advantage (p=0.0506, HR: 0.1187, 95%CI: 0.01401-1.005).Discussion: Biological prognostic factors, such as the Ly/ Mo ratio, may improve the prognostic assessment of staging PET/CT. Nevertheless, PFS difference is translated into OS when using a combination of staging and interim SUVmax. We consider investigating additional biological prognostic factors while currently highlighting PET/CT's role in FL.

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Persistent COVID-19 Pneumonia and Failure to Develop Anti-SARS-CoV-2 Antibodies During Rituximab Maintenance Therapy for Follicular Lymphoma

Cited by 77 publications

References 6 publications

Patterns of seroconversion for SARS-CoV-2 IgG in patients with malignant disease and association with anticancer therapy

Patterns of seroconversion for SARS-CoV-2 IgG in patients with malignant disease and association with anticancer therapy

Response to: ‘Antirheumatic drugs, B cell depletion and critical COVID-19: correspondence on ‘Clinical course of coronavirus disease 2019 (COVID-19) in a series of 17 patients with systemic lupus erythematosus under long-term treatment with hydroxychloroquine by Mathianet al’ by Notzet al

Clinical and Biological Prognostic Factors in Follicular Lymphoma Patients During Treatment

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