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Gaitzsch, E.* ; Passerini, V.* ; Khatamzas, E.* ; Strobl, C.D.* ; Muenchhoff, M.* ; Scherer, C.* ; Osterman, A.* ; Heide, M.* ; Reischer, A.* ; Subklewe, M.* ; Leutbecher, A.* ; Tast, B.* ; Ruhle, A.* ; Weiglein, T.* ; Stecher, S.S.* ; Stemmler, H.J.* ; Dreyling, M.* ; Girl, P.* ; Georgi, E.* ; Wölfel, R.* ; Mateyka, L.* ; D'Ippolito, E.* ; Schober, K.* ; Busch, D.H.* ; Kager, J.* ; Spinner, C.D.* ; Treiber, M.* ; Rasch, S.* ; Lahmer, T.* ; Iakoubov, R.* ; Schneider, J.* ; Protzer, U. ; Winter, C.* ; Ruland, J.* ; Quante, M.* ; Keppler, O.T.* ; von Bergwelt-Baildon, M.* ; Hellmuth, J.C.* ; Weigert, O.*

COVID-19 in Patients Receiving CD20-depleting Immunochemotherapy for B-cell Lymphoma.

Hemasphere 5:e603 (2021)
Publ. Version/Full Text DOI PMC
Open Access Gold
Creative Commons Lizenzvertrag
The clinical and immunological impact of B-cell depletion in the context of coronavirus disease 2019 (COVID-19) is unclear. We conducted a prospectively planned analysis of COVID-19 in patients who received B-cell depleting anti-CD20 antibodies and chemotherapy for B-cell lymphomas. The control cohort consisted of age- and sex-matched patients without lymphoma who were hospitalized because of COVID-19. We performed detailed clinical analyses, in-depth cellular and molecular immune profiling, and comprehensive virological studies in 12 patients with available biospecimens. B-cell depleted lymphoma patients had more severe and protracted clinical course (median hospitalization 88 versus 17 d). All patients actively receiving immunochemotherapy (n = 5) required ICU support including long-term mechanical ventilation. Neutrophil recovery following granulocyte colony stimulating factor stimulation coincided with hyperinflammation and clinical deterioration in 4 of the 5 patients. Immune cell profiling and gene expression analysis of peripheral blood mononuclear cells revealed early activation of monocytes/macrophages, neutrophils, and the complement system in B-cell depleted lymphoma patients, with subsequent exacerbation of the inflammatory response and dysfunctional interferon signaling at the time of clinical deterioration of COVID-19. Longitudinal immune cell profiling and functional in vitro assays showed SARS-CoV-2-specific CD8+ and CD4+ T-effector cell responses. Finally, we observed long-term detection of SARS-CoV-2 in respiratory specimens (median 84 versus 12 d) and an inability to mount lasting SARS-CoV-2 antibody responses in B-cell depleted lymphoma patients. In summary, we identified clinically relevant particularities of COVID-19 in lymphoma patients receiving B-cell depleting immunochemotherapies.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
ISSN (print) / ISBN 2572-9241
e-ISSN 2572-9241
Journal Hemasphere
Quellenangaben Volume: 5, Issue: 7, Pages: , Article Number: e603 Supplement: ,
Publisher Wolters Kluwer Health
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Virology (VIRO)