Pb2286: influence of anti-cd20 monoclonal antibody therapy on the outcome of coronavirus infection covid-19 in patients with lymphoproliferative diseases

Background: The use of monoclonal anti-CD20 antibodies in patients with B-cell non-Hodgkin lymphoma causes a deep and prolonged depletion of the number of B-lymphocytes in the peripheral blood and the suppression of the humoral immune response. In the context of the pandemic of COVID-19, the influence of anti-CD20 monoclonal antibody therapy on the outcome of a coronavirus infection is urgent. Aims: To study the effect of anti-CD20 monoclonal antibody therapy on the outcome of coronavirus infection in patients with lymphoproliferative diseases. Methods: The study included 210 patients with lymphoproliferative diseases treated at City Clinical Hospital №52 in Moscow from March 2020 to November 2021 for COVID-19. There were 117 men (56%) and 93 women (44%). The median age was 58 years (range, 20-92). Eighty-nine per cent of patients had B-cell non-Hodkin lymphoma. At the time of hospitalization 47% of patients were in a complete or partial remission of lymphoma, 18% had a relapse/refractory disease, 24% were at the stage of therapy, a lymphoproliferative disease was detected for the first time in 11%. Results: One hundred sixty-two patients (77%) received anti-CD20 monoclonal antibody therapy before hospitalization, 92% of them received therapy with rituximab and 8% received therapy with obinutuzumab, 80% received anti-CD20 monoclonal antibody therapy for the last 12 months before hospitalization. It was found that among patients who received anti-CD20 monoclonal antibody therapy for the last 12 months, 35 patients (27%) died; 3 (9%) and 6 (13%) patients died, respectively (p=0,020) among ones who received anti-CD20 monoclonal antibody therapy over 12 months ago and who had not previously received this regimen of chemotherapy. In the group of patients treated with obinutuzumab, 6 (46%) died, and in the group of patients treated with rituximab, 28 (19%) died (p=0,004). When comparing the number of deaths in the groups that received anti-CD20 monoclonal antibodies as induction chemotherapy regimens (22%) and as maintenance therapy (19%), statistically significant differences were not found (p>0,05). Forty-five per cent of patients who received anti-CD20 monoclonal antibody therapy for the last 12 months had a longer persistence (more than 3-4 weeks) of the virus SARS-CoV-2 compared with the patients who received anti-CD20 monoclonal antibody therapy more than 12 months ago (22%) (p=0,038). The median hospital stay was 16 days (range, 2-53). During hospitalization 44 patients (21%) with lymphoproliferative diseases died. The 30-day in-hospital survival in patients who received anti-CD20 monoclonal antibody therapy within the last 12 months was 62%, in patients who received anti-CD20 monoclonal antibody therapy more than 12 months ago this was not achieved (p=0,042). Summary/Conclusion: An increase in the number of deaths from COVID-19 and a longer persistence of the virus SARS-CoV-2 are experienced among patients with lymphoproliferative diseases who have received anti-CD20 monoclonal antibody therapy within the last 12 months before hospitalization; all this negatively affect in-hospital survival.