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Could anti-CD20 therapy jeopardise the efficacy of a SARS-CoV-2 vaccine?

Roch Houot1, Ronald Levy2, Guillaume Cartron3

  • 1Department of Hematology, CHU Rennes, University of Rennes, INSERM U1236, Rennes, France; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.

European Journal of Cancer (Oxford, England : 1990)
|July 4, 2020
PubMed

Insights

Anti-CD20 therapy may reduce the effectiveness of SARS-CoV-2 vaccines in patients needing them most. This review highlights potential risks for physicians to consider regarding vaccine efficacy in these vulnerable populations.

Area of Science:

  • Immunology
  • Vaccinology
  • Onco-immunology

Background:

  • The COVID-19 pandemic necessitates effective vaccines for SARS-CoV-2.
  • Patients with hematologic malignancies or autoimmune disorders are at high risk for severe COVID-19.
  • Anti-CD20 therapy is used to treat these conditions but may impact vaccine response.

Purpose of the Study:

  • To review the potential for anti-CD20 therapy to compromise SARS-CoV-2 vaccine efficacy.
  • To alert physicians to this risk when considering vaccination for at-risk patients.
  • To inform the risk/benefit assessment of anti-CD20 therapy during the pandemic.

Main Methods:

  • Literature review and expert opinion synthesis.
  • Analysis of B-cell depletion mechanisms related to anti-CD20 agents.
  • Discussion of implications for vaccine immunogenicity and clinical protection.

Main Results:

  • Anti-CD20 therapy depletes B-cells, which are crucial for vaccine-induced antibody and memory responses.
  • This depletion may lead to diminished or abrogated efficacy of SARS-CoV-2 vaccines.
  • The risk is particularly relevant for patients requiring anti-CD20 treatment for underlying conditions.

Conclusions:

  • Physicians must consider the potential impact of anti-CD20 therapy on SARS-CoV-2 vaccine effectiveness.
  • Careful evaluation of the risk/benefit ratio is essential when administering anti-CD20 therapy during the pandemic.
  • Further research is needed to optimize vaccination strategies for patients on anti-CD20 therapy.
Keywords:
Anti-CD20 antibodyCOVID-19RituximabSARS-CoV-2Vaccine

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