Abstract
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Four B cell–depleted non-Hodgkin lymphoma (NHL) patients with SARS-CoV-2 pneumonia after rituximab therapy were initially treated with a 5-day remdesivir course and steroids. After transient virologic and clinical response, they all experienced early relapse and subsequent prolonged disease course, with rapid and significant response to convalescent hyperimmune plasma in association with an extended course of remdesivir. The clinical observations here reported suggest that the immunological effects of Rituximab treatment in NHL patients should be taken into account for the proper choice and interpretation of SARS-CoV-2 laboratory tests and to guide the appropriate therapeutical approach.
Keywords:
B cell depletion convalescent hyperimmune plasma remdesivir; Rituximab; SARS-CoV-2; non-Hodgkin lymphoma.
MeSH terms
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Adenosine Monophosphate / administration & dosage
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Adenosine Monophosphate / analogs & derivatives*
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Alanine / administration & dosage
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Alanine / analogs & derivatives*
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B-Lymphocytes / pathology
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COVID-19 / complications
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COVID-19 / therapy*
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COVID-19 Drug Treatment
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COVID-19 Serotherapy
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Combined Modality Therapy
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Drug Administration Schedule
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Humans
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Immunization, Passive / methods
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Immunocompromised Host
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Immunosuppressive Agents / adverse effects
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Immunosuppressive Agents / therapeutic use
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Italy
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Lymphoma, Non-Hodgkin / complications
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Lymphoma, Non-Hodgkin / pathology
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Lymphoma, Non-Hodgkin / therapy*
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Lymphopenia / etiology
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Lymphopenia / pathology
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Lymphopenia / therapy
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Male
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Middle Aged
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Pneumonia, Viral / complications
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Pneumonia, Viral / therapy
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Rituximab / adverse effects
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Rituximab / therapeutic use*
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SARS-CoV-2 / physiology
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Treatment Outcome
Substances
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Immunosuppressive Agents
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remdesivir
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Adenosine Monophosphate
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Rituximab
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Alanine