Rituximab suppresses anti-S COVID-19 antibodies in patients with haematological malignancies

12 Oct 2021
GSI, CSI, cancer, NUS, discovery, EZH2, lymphomas, progression
GIS, CSI make first collaborative discovery on cancer progression

While patients with haematological malignancies (HM) are able to mount a persistent antibody response against the spike (S) protein of the SARS-CoV-2 virus, early treatment with rituximab completely abolishes such response, a recent study has found. These findings could help inform coronavirus disease 2019 (COVID-19) vaccination policies for patients with HMs.

Researchers prospectively assessed 45 patients (median age 69 years, 26 men) with HMs and confirmed COVID-19. Antibody levels against the S and nucleocapsid (N) antigens were measured using fluid-phase luciferase-immunoprecipitation assays at 1, 3, and 6 months after the nasal swabs tested negative. A parallel group of 18 COVID-19 patients (median age 54 years, seven men) without HM was also included.

Levels of anti-S antibodies were comparable between patients and controls at the first month after a negative nasal swab test, and remained statistically stable at months 3 and 6. Similarly, anti-N-antibodies had similar between-group levels at all time points except for month 1, during which HM patients showed significant elevation (p=0.016).

Fourteen participants with non-Hodgkin lymphoma were on rituximab treatment, five of whom had received such medication for ≥6 months before COVID-19, while medication was ongoing in the remaining nine. Levels of anti-S antibodies were significantly suppressed in patients with ongoing rituximab than in those whose courses had already ended (month 1: p=0.000039; month 3: p=0.003; month 6: p=0.04).

There were differences in humoral response according to haematologic diagnoses, too. In particular, patients with lymphoma mounted a weaker antibody response compared with any other HM at any time point.

Editor's Recommendations