Efficacy of Combination of Antiviral Therapy With Neutralizing Monoclonal Antibodies for Recurrent Persistent SARS-CoV-2 Pneumonia in Patients With Lymphoma.

Publisher: Hindawi Pub. Co Country of Publication: United States NLM ID: 101600173 Publication Model: eCollection Cited Medium: Internet ISSN: 2314-6141 (Electronic) NLM ISO Abbreviation: Biomed Res Int Subsets: MEDLINE

Original Publication: New York, NY : Hindawi Pub. Co.

Antibodies, Neutralizing*/therapeutic use ; Antiviral Agents*/therapeutic use ; SARS-CoV-2*/immunology ; Lymphoma*/drug therapy ; Lymphoma*/complications ; COVID-19*/immunology ; COVID-19*/complications ; COVID-19 Drug Treatment* ; Ritonavir*/therapeutic use; Humans ; Male ; Middle Aged ; Female ; Aged ; Prospective Studies ; Adult ; Antibodies, Monoclonal, Humanized/therapeutic use ; Treatment Outcome ; Drug Combinations ; Recurrence ; Lopinavir/therapeutic use ; Antibodies, Viral/immunology ; Antibodies, Viral/therapeutic use

Despite the potential of neutralizing antibodies in the management of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), clinical research on its efficacy in Chinese patients remains limited. This study is aimed at investigating the therapeutic effect of combination of antiviral therapy with neutralizing monoclonal antibodies for recurrent persistent SARS-CoV-2 pneumonia in patients with lymphoma complicated by B cell depletion. A prospective study was conducted on Chinese patients who were treated with antiviral nirmatrelvir/ritonavir therapy and the neutralizing antibody tixagevimab-cilgavimab (tix-cil). The primary outcome was the rate of recurrent SARS-CoV-2 infection. Five patients with lymphoma experienced recurrent SARS-CoV-2 pneumonia and received tix-cil treatment. All patients had a history of CD20 monoclonal antibody use within the year preceding SARS-CoV-2 infection, and two patients also had a history of Bruton's tyrosine kinase (BTK) inhibitor use. These patients had notably low lymphocyte counts and exhibited near depletion of B cells. All five patients tested negative for serum SARS-CoV-2 IgG and IgM antibodies. None of the patients developed reinfection with SARS-CoV-2 pneumonia after antiviral and tix-cil treatment during the 6-month follow-up period. In conclusion, the administration of antiviral and SARS-CoV-2-neutralizing antibodies showed encouraging therapeutic efficacy against SARS-CoV-2 pneumonia in patients with lymphoma complicated by B cell depletion, along with the potential preventive effect of neutralizing antibodies for up to 6 months.
Competing Interests: The authors declare no conflicts of interest.
(Copyright © 2024 Xiaoyan Gai et al.)

Hemasphere. 2021 Feb 10;5(3):e538. (PMID: 33604516)
Hematol Oncol. 2023 Feb;41(1):3-15. (PMID: 36251481)
Nat Rev Immunol. 2021 Jun;21(6):382-393. (PMID: 33875867)
Nat Commun. 2022 Feb 14;13(1):864. (PMID: 35165284)
Nat Med. 2021 Jul;27(7):1178-1186. (PMID: 33953384)
Blood. 2020 Nov 12;136(20):2290-2295. (PMID: 32959052)
Clin Infect Dis. 2021 Sep 15;73(6):e1397-e1401. (PMID: 33949644)
Clin Lymphoma Myeloma Leuk. 2021 Oct;21(10):e810-e816. (PMID: 34393077)
Blood. 2022 Jul 21;140(3):236-252. (PMID: 35544585)
Blood. 2023 Jan 12;141(2):200-203. (PMID: 36332185)
Cancer Cell. 2022 Jun 13;40(6):590-591. (PMID: 35598602)
Blood Adv. 2022 Mar 8;6(5):1537-1546. (PMID: 35114690)
Nature. 2021 Apr;592(7853):277-282. (PMID: 33545711)
Clin Microbiol Infect. 2023 Mar;29(3):332-337. (PMID: 36336236)
Front Med (Lausanne). 2024 Feb 29;11:1344267. (PMID: 38487021)
Blood Adv. 2022 Jun 14;6(11):3230-3233. (PMID: 35026843)
Lancet Respir Med. 2022 Oct;10(10):985-996. (PMID: 35688164)
Front Med (Lausanne). 2021 Oct 06;8:686247. (PMID: 34692715)
J Infect Dis. 2020 Jul 6;222(3):367-371. (PMID: 32474608)
Clin Infect Dis. 2023 Jul 26;77(2):280-286. (PMID: 36976301)
Br J Haematol. 2023 May;201(4):628-639. (PMID: 36806152)
J Med Virol. 2020 Oct;92(10):2105-2113. (PMID: 32383269)
N Engl J Med. 2022 Jun 9;386(23):2188-2200. (PMID: 35443106)
Antibodies (Basel). 2023 Feb 23;12(1):. (PMID: 36975364)
Front Immunol. 2022 Jan 10;12:782506. (PMID: 35082779)
Blood. 2022 Mar 10;139(10):1588-1592. (PMID: 34748627)
Hum Immunol. 2021 Sep;82(9):649-658. (PMID: 34020832)
Int J Antimicrob Agents. 2024 Mar;63(3):107095. (PMID: 38244814)

Keywords: CD20 monoclonal antibody; SARS-CoV-2 pneumonia; immunocompromised patient; lymphoma; neutralizing antibodies

0 (Antibodies, Neutralizing)
0 (Antiviral Agents)
O3J8G9O825 (Ritonavir)
0 (Antibodies, Monoclonal, Humanized)
0 (Drug Combinations)
2494G1JF75 (Lopinavir)
0 (Antibodies, Viral)
0 (lopinavir-ritonavir drug combination)

Date Created: 20240814 Date Completed: 20240814 Latest Revision: 20240815

20240815

PMC11321881

10.1155/2024/8182887

39140001