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Updated: Dec 13, 2025
In Vitro Differentiation Model of Human Normal Memory B Cells to Long-lived Plasma Cells
Published on: January 20, 2019
Tailoring B cell depletion therapy in MS according to memory B cell monitoring
Giovanni Novi1, Francesca Bovis2, Sabrina Fabbri2
1From the Department of Neuroscience (G.N.), Ospedale Policlinico San Martino-IRCCS; Department of Health Sciences (DISSAL) (F.B., I.M., L.R., M.S.), University of Genova, Italy; Ospedale A. Micone (S.F., P.G.), Genova; Department of Neuroscience (F.T., N.B., G.B., C.L., M.C., A.L., E.C., G.M.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova; Ospedale Policlinico San Martino-IRCCS (F.T., N.B., L.R., A.L., E.C., M.S., M.I., A.U.), Genova, Italy; Ospedale San Paolo (D.C.), Savona; Autoimmunity Laboratory DiMI (G.P.), University of Genova, Italy; Monsignor Luigi Novarese Rehabilitation Center (C.S.), Moncrivello, Vercelli; Istituti Clinici Scientifici Maugeri (G.M.), IRCCS, Pavia; and Department of Neuroscience (M.I., A.U.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) and Center of Excellence for Biomedical Research (CEBR), University of Genova, Italy. giovanninovi@gmail.com.
Objective:
We wanted to evaluate efficacy on inflammatory parameters of rituximab (RTX)-personalized reinfusion scheme using a memory B cell-based treatment regimen.
Methods:
This is a prospective, uncontrolled, open-label study including patients with MS treated with RTX in 2 Italian MS units. All patients were treated with RTX induction, followed by maintenance infusion at the dosage of 375 mg/m2, according to memory B cell repopulation (0.05% of peripheral-blood mononuclear cells [PBMCs] for the first 2 years, 0.1% of PBMC for the third year). MS activity was assessed as clinical or MRI activity.
Results:
One hundred two patients were included in the analysis. Mean follow-up was 2.40 years (range 0.57-7.15 years). The annualized relapse rate (ARR) was 0.67 in the year before RTX start and decreased to 0.01 in the 3 years after RTX initiation (global ARR). The proportion of patient with MS activity (i.e., relapse or MRI activity) was 63.16% in the year before RTX start and decreased to 8.7% (0-6 months), 1.3% (6-12 months), 0% (12-24 months), and 0% (24-36 months). Annualized RTX infusion rates were 1.67 (95% confidence interval [CI]: 1.43-1.94), 0.76 (95% CI: 0.58-0.98), and 0.78 (95% CI: 0.52-1.12) for the first 3 years after RTX initiation, respectively. Patients were reinfused with a mean infusion interval of 367 days (range 181-839 days).
Conclusion:
The results of this study show that the memory B cell-based RTX reinfusion protocol is able to reduce the mean number of RTX reinfusions with persistent reduction of disease activity.
Classification Of Evidence:
This study provides Class IV evidence that for patients with MS, a memory B cell-based RTX reinfusion protocol can reduce the mean number of RTX reinfusions with persistent reduction of disease activity.
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