Anti-CD20 maintenance strategies to face the challenge of COVID-19 pandemic in follicular lymphoma: results from the R-FolSTOP multicentre Italian study

IF 3 3区医学 Q2 HEMATOLOGY

Annals of Hematology Pub Date : 2025-03-12 DOI:10.1007/s00277-025-06295-0

Alessia Castellino, Lorenzo Comba, Laura Bertolotti, Carola Boccomini, Michele Clerico, Paolo Nicoli, Anna Vanazzi, Fulvia Fanelli, Tommasina Perrone, Francesco Marchesi, Federica Cocito, Michele Merli, Sara Bigliardi, Bianca Mecacci, Valentina Bozzoli, Gloria Margiotta-Casaluci, Erika Meli, Antonella Anastasia, Lucia Farina, Ombretta Annibali, Annarita Conconi, Sara Rattotti, Sara Galimberti, Claudia Castellino, Massimo Massaia

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引用次数: 0

Abstract

The SARS-CoV2 pandemic has posed unprecedented challenges between temporary or permanent discontinuation of immunosuppressive treatment to protect patients, or disease control prioritization by not interrupting treatment. Maintenance treatment with anti-CD20 monoclonal antibodies (MoAbs) improves progression-free survival (PFS) in follicular lymphoma (FL), but also impairs anti-SARS-CoV2 immune response. This challenge has been addressed in Italy by temporary, definitive or no discontinuation of anti-CD20 treatment. We report the outcome of 539 FL patients receiving anti-CD20 MoAbs (rituximab in 431, obinutuzumab in 108), which were temporarily discontinued in 150 patients (group A), definitively discontinued in 166 (group B), or uninterrupted in 223 (group C). In the overall cohort, the 3-year progression-free survival (3y PFS) and 3-year overall survival (3y OS) rates were 80% and 88%. PFS and OS were significantly better in group A compared to group B and C (p = 0.01). Induction chemoimmunotherapy significantly influenced OS: the 3y OS was 91% vs 85% in CHOP vs bendamustine treated patients (p = 0.04), while the 3y OS was 90% vs 77% in rituximab vs obinutuzumab treated patients (p = 0.002). SARS-Cov2 infection was the main cause of death (67% of cases). Vaccination with multiple doses demonstrated to be clinically helpful, with impact on OS.

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抗cd20维持策略应对COVID-19大流行对滤泡性淋巴瘤的挑战：来自意大利R-FolSTOP多中心研究的结果

SARS-CoV2大流行带来了前所未有的挑战，是暂时或永久停止免疫抑制治疗以保护患者，还是通过不中断治疗来优先控制疾病。抗cd20单克隆抗体（MoAbs）维持治疗可改善滤泡性淋巴瘤（FL）的无进展生存期（PFS），但也会损害抗sars - cov2免疫应答。意大利通过暂时、最终或不停止抗cd20治疗来应对这一挑战。我们报告了539例FL患者接受抗cd20 MoAbs（431例为利妥昔单抗，108例为obinutuzumab）治疗的结果，其中150例患者（A组）暂时停药，166例（B组）最终停药，223例（C组）不间断。在整个队列中，3年无进展生存率（3y PFS）和3年总生存率（3y OS）分别为80%和88%。A组PFS、OS明显优于B、C组（p = 0.01）。诱导化学免疫治疗显著影响OS: CHOP与苯达莫司汀治疗患者的3年OS分别为91%和85% (p = 0.04)，而利妥昔单抗与obinutuzumab治疗患者的3年OS分别为90%和77% （p = 0.002）。SARS-Cov2感染是主要死亡原因（67%）。多剂量疫苗接种在临床上证明是有帮助的，对OS有影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Hematology 医学-血液学

CiteScore

5.60

自引率

2.90%

发文量

304

审稿时长

2 months

期刊介绍： Annals of Hematology covers the whole spectrum of clinical and experimental hematology, hemostaseology, blood transfusion, and related aspects of medical oncology, including diagnosis and treatment of leukemias, lymphatic neoplasias and solid tumors, and transplantation of hematopoietic stem cells. Coverage includes general aspects of oncology, molecular biology and immunology as pertinent to problems of human blood disease. The journal is associated with the German Society for Hematology and Medical Oncology, and the Austrian Society for Hematology and Oncology.