Evidence map›Paper›PMID 40332719›Full record

Observational studyInfection2025

Delayed but successful development of immune memory against SARS-COV-2 after B cell-depleting monotherapy.

Nicolas Graf, Joseph Bayerl, Barbara Schmidt

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Nicolas GrafMedical Department II, Section Oncology, Donau-Isar-Klinikum Deggendorf, Deggendorf, Germany. nicolasgraf@gmx.de.
Joseph BayerlInstitute for Laboratory Diagnostics, Immunohaematology and Microbiology, Donau-Isar-Klinikum Deggendorf, Deggendorf, Germany.
Barbara SchmidtInstitute of Microbiology and Hygiene, Clinical Virology and Infection Immunology, University Hospital Regensburg, Regensburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePatients receiving CD20-directed therapies are known to insufficiently develop neutralizing antibody titers against SARS-COV-2 after two vaccinations. We investigated the impact of a third and fourth vaccination, possibly deriving predictive factors.

methodsIn a monocentric, prospective, non-interventional observational study patients who had received at least one administration of a monoclonal CD20 antibody (mCD20Ab) within 9 months prior to vaccination were included to receive mRNA-based third vaccination. SARS-COV-2 IgG titer was determined before and four weeks after immunisation. Patients without adequate humoral immune response proceeded to a fourth vaccination. Furthermore, tolerability and prespecified potentially influencing factors such as age, baseline lymphocyte counts and others were analysed.

resultsTwenty-four patients were included and vaccination was well tolerated. Quantitative analysis of humoral response four weeks after third vaccination revealed a significant increase which, however, did not translate into a clinically relevant seroconversion rate. In the subgroup analysis, patients older than 65 years and mCD20Ab therapy longer than 6 months ago benefited. All evaluable patients on mCD20Ab monotherapy (n = 7) showed an immediate or delayed immune response after third vaccination, while all non-responders (n = 7) were on combination therapy. Clinical parameters such as lymphocyte count, immunoglobulin status and others did not appear to have any influence.

conclusionAn interval of at least 6 months after the last mCD20Ab administration and mCD20Ab monotherapy appears to be favorable for humoral immune response to third vaccination. Furthermore, patients can be reassured that delayed immune responses are possible. Future studies should therefore also investigate seroconversion at later time points.

Indexed as

B-LymphocytesCOVID-19COVID-19 VaccinesImmunologic MemorySARS-CoV-2AdultAgedAged, 80 and overAntibodies, NeutralizingAntibodies, ViralBNT162 VaccineFemaleHumansImmunoglobulin GMaleMiddle AgedAntibodies, NeutralizingAntibodies, ViralBNT162 VaccineCOVID-19 VaccinesImmunoglobulin GAntibodiesB-cell depletionImmune memorySARS-CoV-2Vaccination

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.