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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, Thomas Kelly, Melanie Qureshi, Iman Salhan, Beena Karim, Farheen
Shields, Adrian M.
Venkatachalam, Srinivasan
Shafeek, Salim
Paneesha, Shankara
Ford, Mark
Sheeran, Thomas
Kelly, Melanie
Qureshi, Iman
Salhan, Beena
Karim, Farheen
Authors
Shields, Adrian M.
Venkatachalam, Srinivasan
Shafeek, Salim
Paneesha, Shankara
Ford, Mark
Sheeran, Thomas
Kelly, Melanie
Qureshi, Iman
Salhan, Beena
Karim, Farheen
De Silva, Neelakshi
Stones, Jacqueline
Lee, Sophie
Khawaja, Jahanzeb
Kumar Kaudlay, Praveen
Whitmill, Richard
Nabi Kakepoto, Ghulam
Parry, Helen M.
Moss, Paul
Faustini, Sian
Richter, Alex G.
Drayson, Mark
Basu, Supratik
Venkatachalam, Srinivasan
Shafeek, Salim
Paneesha, Shankara
Ford, Mark
Sheeran, Thomas
Kelly, Melanie
Qureshi, Iman
Salhan, Beena
Karim, Farheen
De Silva, Neelakshi
Stones, Jacqueline
Lee, Sophie
Khawaja, Jahanzeb
Kumar Kaudlay, Praveen
Whitmill, Richard
Nabi Kakepoto, Ghulam
Parry, Helen M.
Moss, Paul
Faustini, Sian
Richter, Alex G.
Drayson, Mark
Basu, Supratik
Editors
Other contributors
Affiliation
Epub Date
Issue Date
2021-11-30
Submitted date
Alternative
Abstract
B cell depleting agents are amongst 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 (<1m) 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 (>36m 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.
Citation
Shields, A.M., Venkatachalam, S., Shafeek, S. et al. (2021) SARS-CoV-2 vaccine responses following CD20-depletion treatment in patients with haematological and rheumatological disease: a West Midlands Research Consortium study. Clinical and Experimental Immunology, 207(1), pp. 3–10, https://doi.org/10.1093/cei/uxab018
Publisher
Research Unit
PubMed ID
PubMed Central ID
Embedded videos
Type
Journal article
Language
en
Description
© 2021 The Authors. Published by Oxford Academic. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1093/cei/uxab018
Series/Report no.
ISSN
0009-9104