Anti-CD20 therapy & coronavirus infection: The timing of vaccination and therapy on vaccine response

What is it about?

COVID-19 is more likely to be fatal in patients with blood cancer, such as those with B cell Hodgkin lymphoma (B-NHL). This is because these patients have a weak immune system owing to the disease’s biology and use of therapies. Vaccines against COVID-19 have reduced the rate of hospitalization and death across the world. But, patients with B-NHL do not have an optimal reaction to the vaccine. Such patients include those receiving B cell targeted therapies like “CD20 targeting antibodies” and “Bruton tyrosine kinase inhibitors.” It is not clear how the timing of these therapies impact vaccination. To address this gap, researchers checked if patients with B-NHL had impaired responses to the vaccine. To do so, they assessed blood levels of specific antibodies, such as blocking antibodies, anti-spike antibodies, and spike-specific B cells, of 126 patients with B-NHL. They found that receiving the vaccine prior to therapy led to an immune response in the patients that remained even after therapy. No immune response was observed in patients who were vaccinated after therapy. The study also found that induced antibodies and memory B cells (a specific type of immune cell) were able to recognize the Delta variant of the virus. The decay of antibody response in patients with B-NHL was similar to that in healthy people.

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Photo by Jeremy Bezanger on Unsplash

Photo by Jeremy Bezanger on Unsplash

Why is it important?

This was the first study that tested the strategy of vaccination prior to treatment for B-NHL. The findings show that the immunity conferred by vaccines stays even after treatment with anti-CD20 therapies. This study suggests that vaccine responses can be improved by managing the timing of these therapies. KEY TAKEAWAY: The study suggests that vaccine responses in patients with B-NHL rely on the timing between therapies and vaccination. These patients should be immunized to the virus before they start with anti-CD20 therapy.