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SARS-CoV-2 vaccine responses following CD20-depletion treatment in patients with haematological and rheumatological disease: a West Midlands Research Consortium study.
Shields, Adrian M; Venkatachalam, Srinivasan; Shafeek, Salim; Paneesha, Shankara; Ford, Mark; Sheeran, Tom; Kelly, Melanie; Qureshi, Iman; Salhan, Beena; Karim, Farheen; De Silva, Neelakshi; Stones, Jacqueline; Lee, Sophie; Khawaja, Jahanzeb; Kaudlay, Praveen Kumar; Whitmill, Richard; Kakepoto, Ghulam Nabi; Parry, Helen M; Moss, Paul; Faustini, Sian E; Richter, Alex G; Drayson, Mark T; Basu, Supratik.
  • Shields AM; Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
  • Venkatachalam S; Department of Clinical Immunology, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
  • Shafeek S; Department of Rheumatology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Paneesha S; Department of Haematology, Worcestershire Acute NHS Trust, Worcester, UK.
  • Ford M; Department of Haematology, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
  • Sheeran T; Department of Rheumatology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Kelly M; Department of Rheumatology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Qureshi I; Department of Haematology, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
  • Salhan B; Department of Haematology, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
  • Karim F; Department of Haematology, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
  • De Silva N; Department of Haematology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Stones J; Department of Haematology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Lee S; Department of Haematology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Khawaja J; Department of Haematology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Kaudlay PK; Department of Haematology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Whitmill R; Department of Haematology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Kakepoto GN; Department of Haematology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Parry HM; Department of Haematology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Moss P; Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
  • Faustini SE; Department of Haematology, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
  • Richter AG; Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
  • Drayson MT; Department of Haematology, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
  • Basu S; Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
Clin Exp Immunol ; 207(1): 3-10, 2022 01 28.
Article in English | MEDLINE | ID: covidwho-1621554
ABSTRACT
B-cell-depleting agents are among the most commonly used drugs to treat haemato-oncological and autoimmune diseases. They rapidly induce a state of peripheral B-cell aplasia with the potential to interfere with nascent vaccine responses, particularly to novel antigens. We have examined the relationship between B-cell reconstitution and SARS-CoV-2 vaccine responses in two cohorts of patients previously exposed to B-cell-depleting agents a cohort of patients treated for haematological B-cell malignancy and another treated for rheumatological disease. B-cell depletion severely impairs vaccine responsiveness in the first 6 months after administration SARS-CoV-2 antibody seroprevalence was 42.2% and 33.3% in the haemato-oncological patients and rheumatology patients, respectively and 22.7% in patients vaccinated while actively receiving anti-lymphoma chemotherapy. After the first 6 months, vaccine responsiveness significantly improved during early B-cell reconstitution; however, the kinetics of reconstitution was significantly faster in haemato-oncology patients. The AstraZeneca ChAdOx1 nCoV-19 vaccine and the Pfizer BioNTech 162b vaccine induced equivalent vaccine responses; however, shorter intervals between vaccine doses (<1 m) improved the magnitude of the antibody response in haeamto-oncology patients. In a subgroup of haemato-oncology patients, with historic exposure to B-cell-depleting agents (>36 m previously), vaccine non-responsiveness was independent of peripheral B-cell reconstitution. The findings have important implications for primary vaccination and booster vaccination strategies in individuals clinically vulnerable to SARS-CoV-2.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rheumatic Diseases / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: Clin Exp Immunol Year: 2022 Document Type: Article Affiliation country: Cei

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rheumatic Diseases / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: Clin Exp Immunol Year: 2022 Document Type: Article Affiliation country: Cei