Impaired response to influenza vaccine associated with persistent memory B cell depletion in non-Hodgkin's lymphoma patients treated with rituximab-containing regimens

Davide Bedognetti, Gabriele Zoppoli, Carlotta Massucco, Elisa Zanardi, Simonetta Zupo, Andrea Bruzzone, Mario Roberto Sertoli, Enrico Balleari, Omar Racchi, Marco Messina, Graziano Caltabiano, Giancarlo Icardi, Paolo Durando, Francesco M. Marincola, Francesco Boccardo, Manlio Ferrarini, Filippo Ansaldi, Andrea De Maria

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Abstract

Influenza vaccination is generally recommended for non-Hodgkin's lymphoma (NHL) patients, but no data are available about the activity of this vaccine after treatment with rituximab-containing regimens. We evaluated the humoral response to the trivalent seasonal influenza vaccine in a group of NHL patients in complete remission for ≥6 mo (median, 29 mo) after treatment with rituximab-containing regimens (n = 31) compared with age-matched healthy subjects (n = 34). B cell populations and incidence of influenza-like illness were also evaluated. For each viral strain, the response was significantly lower in patients compared with controls and was particularly poor in patients treated with fludarabine-based regimens. In the patient group, the response to vaccination did not fulfill the immunogenic criteria based on the European Committee for Medicinal Products for Human Use requirements. Among the patients, CD27+ memory B cells were significantly reduced, and their reduction correlated with serum IgM levels and vaccine response. Episodes of influenza-like illness were recorded only in patients. These results showed that NHL patients treated with rituximab-containing regimens have persisting perturbations of B cell compartments and Ig synthesis and may be at particular risk for infection, even in long-standing complete remission.

Original languageEnglish
Pages (from-to)6044-6055
Number of pages12
JournalJournal of Immunology
Volume186
Issue number10
DOIs
Publication statusPublished - 15 May 2011
Externally publishedYes

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ASJC Scopus subject areas

  • Immunology

Cite this

Bedognetti, D., Zoppoli, G., Massucco, C., Zanardi, E., Zupo, S., Bruzzone, A., Sertoli, M. R., Balleari, E., Racchi, O., Messina, M., Caltabiano, G., Icardi, G., Durando, P., Marincola, F. M., Boccardo, F., Ferrarini, M., Ansaldi, F., & De Maria, A. (2011). Impaired response to influenza vaccine associated with persistent memory B cell depletion in non-Hodgkin's lymphoma patients treated with rituximab-containing regimens. Journal of Immunology, 186(10), 6044-6055. https://doi.org/10.4049/jimmunol.1004095