Impact of SARS-CoV-2 infection on bispecific antibody treatment in patients with B-cell lymphoproliferative disorders
Despite advances in vaccination and the use of antiviral treatments, patients with hematologic malignancies, including B-cell lymphoproliferative disorders, are particularly vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The recent introduction of bispecific antibodies (BsAbs) in the treatment algorithm of relapsed/refractory B-cell non-Hodgkin lymphoma (B-NHL) has raised concerns regarding their impact on COVID-19 outcomes. This study aimed to evaluate the impact of SARS-CoV-2 infection on treatment outcomes in patients receiving BsAbs. We assessed the severity of COVID-19 and SARS-CoV-2 serostatus, with antibody titers measured before, during, and after BsAbs administration. A total of 109 patients with B-NHL treated with BsAbs from March 2020 to January 2023 were included. SARS-CoV-2 infection was observed in 56 patients (51%), with 36% experiencing prolonged viral shedding, causing therapy delays in 78% of patients and permanent discontinuations in 19%. Regarding COVID-19 severity, 36% of patients presented moderate, 20% severe, and 12% critical disease. Seven patients (13%) died owing to COVID-19 pneumonia. Similar to observations with anti-CD20 monoclonal antibodies, BsAbs were associated with negative antispike serostatus for at least 6 months after treatment completion. Importantly, this lack of seroconversion was linked with severe disease and increased mortality. These findings underscore important considerations for the management of patients receiving BsAbs.
Authors
- Adaia Albasanz‐Puig (ORCID: https://orcid.org/0000-0001-9852-5574)
- Ana Marín‐Niebla (ORCID: https://orcid.org/0000-0002-7592-6815)
- Anna Falcó-Roget (ORCID: https://orcid.org/0009-0003-1774-679X)
- Josu Iraola‐Truchuelo (ORCID: https://orcid.org/0000-0002-9909-3715)
- Juliana Esperalba (ORCID: https://orcid.org/0000-0003-1326-1341)
- Moraima Jiménez (ORCID: https://orcid.org/0000-0003-1444-8562)
- Marta Crespo (ORCID: https://orcid.org/0000-0002-7732-7808)
- Gloria Iacoboni (ORCID: https://orcid.org/0000-0003-0805-9288)
- Cecilia Carpio (ORCID: https://orcid.org/0000-0001-9346-0134)
- Isabel Ruíz-Camps (ORCID: https://orcid.org/0000-0003-3743-2379)
- Tomás García-Cerecedo (ORCID: https://orcid.org/0000-0002-9670-0495)
- Francesc Bosch (ORCID: https://orcid.org/0000-0001-9241-2886)
- Cristina Andrés (ORCID: https://orcid.org/0000-0002-3200-0895)
- Andrés Antón (ORCID: https://orcid.org/0000-0002-1476-0815)
- Ángel Serna (ORCID: https://orcid.org/0000-0001-7532-9634)
- Ainara Ferrero
- Vı́ctor Navarro (ORCID: https://orcid.org/0000-0001-6925-4605)
- Marc Bosch
- Pau Abrisqueta (ORCID: https://orcid.org/0000-0003-3028-7500)
- Cristina García-Herce (ORCID: https://orcid.org/0000-0002-4180-4713)
Institutions
- Hebron University (PS)
- Universitat Autònoma de Barcelona (ES)
- Hospital Universitari Arnau de Vilanova (ES)
- Vall d'Hebron Institut de Recerca (ES)
- Hospital Arnau de Vilanova (ES)
- Vall d'Hebron Hospital Universitari (ES)
- Vall d'Hebron Institute of Oncology (ES)
Publication Details
- Journal
- Blood Advances
- Published
- 2025-05-22
- DOI
- https://doi.org/10.1182/bloodadvances.2024015406
- Citations
- 3
- Primary Topic
- Lymphoma Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 4.41
Funders
- Pfizer
- AstraZeneca
- Gilead Sciences
- Celgene
- BeiGene
- Incyte
- Instituto de Salud Carlos III