期刊
JOURNAL OF CLINICAL MEDICINE
卷 11, 期 6, 页码 -出版社
MDPI
DOI: 10.3390/jcm11061739
关键词
COVID-19; Rituximab; vaccination
资金
- Dietmar Hopp Stiftung [1DH2111111]
- Physician Scientist Program of the Heidelberg Faculty of Medicine
- Rahel Goitein-Strauss Program of the Heidelberg Faculty of Medicine
- program for surveillance and control of SARS-CoV-2 mutations of the State of Baden-Wurttemberg
- German Federal Research Network Applied Surveillance and Testing (BFAST)
- Helmholtz Association's Initiative and Networking Fund
In patients treated with Rituximab, waiting at least 8-12 months after the last treatment before administering the anti-SARS-CoV-2 vaccine can lead to sufficient humoral responses.
Background: To characterize humoral response after standard anti-SARS-CoV-2 vaccination in Rituximab-treated patients and to determine the optimal time point after last Rituximab treatment for appropriate immunization. Methods: Sixty-four patients who received Rituximab within the last seven years prior to the first anti-SARS-CoV-2 vaccination were recruited in a prospective observational study. Anti-S1 IgG, SARS-CoV-2 specific neutralization, and various SARS-CoV-2 target antibodies were determined. A live virus assay was used to assess neutralizing antibody activity against B.1.617.2 (delta). In Rituximab-treated patients, CD19(+) peripheral B-cells were quantified using flow cytometry. Results: After second vaccination, all antibodies were significantly reduced compared to healthy controls. Neutralizing antibody activity against B.1.617.2 (delta) was detectable with a median (IQR) ID50 of 0 (0-1:20) compared to 1:320 (1:160-1:320) in healthy controls (for all p < 0.001). Longer time period since last Rituximab administration correlated with higher anti-SARS-CoV-2 antibody levels and a stronger neutralization of B.1.617.2 (delta). With one exception, only patients with a CD19(+) cell proportion >= 1% had detectable neutralizing antibodies. Conclusion: Our data indicate that a reconstitution of the B-cell population to >1% seems crucial in developing neutralizing antibodies against SARS-CoV-2. We suggest that anti-SARS-CoV-2 vaccination should be administered at least 8-12 months after the last Rituximab treatment for sufficient humoral responses.
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