Fatal Outcome of COVID-19 Relapse in a Fully Vaccinated Patient with Non-Hodgkin Lymphoma Receiving Maintenance Therapy with the Anti-CD20 Monoclonal Antibody Obinutuzumab: A Case Report
Federica Calò,
Lorenzo Onorato,
Mariantonietta Pisaturo,
Antonio Pinto,
Loredana Alessio,
Caterina Monari,
Carmine Minichini,
Manuela Arcamone,
Alessandra Di Fraia,
Luigi Atripaldi,
Claudia Tiberio,
Nicola Coppola
Affiliations
Federica Calò
Department of Mental Health and Public Medicine—Infectious Diseases Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Lorenzo Onorato
Department of Mental Health and Public Medicine—Infectious Diseases Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Mariantonietta Pisaturo
Department of Mental Health and Public Medicine—Infectious Diseases Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Antonio Pinto
Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione ‘G. Pascale’, IRCCS, 80131 Naples, Italy
Loredana Alessio
Department of Mental Health and Public Medicine—Infectious Diseases Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Caterina Monari
Department of Mental Health and Public Medicine—Infectious Diseases Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Carmine Minichini
Department of Mental Health and Public Medicine—Infectious Diseases Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Manuela Arcamone
Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione ‘G. Pascale’, IRCCS, 80131 Naples, Italy
Alessandra Di Fraia
Department of Mental Health and Public Medicine—Infectious Diseases Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Luigi Atripaldi
U.O.C. di Patologia Clinica Ospedale D. Cotugno, Azienda Sanitaria Ospedali dei Colli, 80131 Naples, Italy
Claudia Tiberio
U.O.C. di Patologia Clinica Ospedale D. Cotugno, Azienda Sanitaria Ospedali dei Colli, 80131 Naples, Italy
Nicola Coppola
Department of Mental Health and Public Medicine—Infectious Diseases Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
Few data are available regarding the effectiveness of anti-SARS-CoV-2 vaccine in immunocompromised patients. Vaccination may have a suboptimal efficacy in this population, in particular if patients are exposed to anti-B-cell therapy. We report the virological and clinical characteristics of a patient with follicle center lymphoma under bimonthly maintenance therapy with obinutuzumab, an anti-CD20 monoclonal antibody. Despite three doses of BNT162b2 vaccine, the patient was infected by the SARS-CoV-2 Omicron variant. After an initial period of clinical and molecular remission due to early therapy with sotrovimab, the patient experienced a fatal relapse sustained by the same viral strain.
