TY - JOUR T1 - Correspondence on ‘SARS-CoV-2 vaccination in rituximab-treated patients: evidence for impaired humoral but inducible cellular immune response’ JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis DO - 10.1136/annrheumdis-2021-220756 SP - annrheumdis-2021-220756 AU - Timm H Westhoff AU - Felix S Seibert AU - Moritz Anft AU - Arturo Blazquez-Navarro AU - Sarah Skrzypczyk AU - Adrian Doevelaar AU - Bodo Hölzer AU - Krystallenia Paniskaki AU - Sebastian Dolff AU - Benjamin Wilde AU - Oliver Witzke AU - Juergen Braun AU - Ulrik Stervbo AU - Nina Babel Y1 - 2021/07/16 UR - http://ard.bmj.com/content/early/2021/07/16/annrheumdis-2021-220756.abstract N2 - We read with a great interest the article published by Bonelli et al suggesting an inducible cellular immune response in rituximab (Rtx) treated patients.1 The CD20-antibody Rtx is one of the most widespread biologicals worldwide with a broad spectrum of oncological and rheumatological indications. Due to its depleting effect on circulating B cells, the generation of antibodies against novel pathogens is impaired in Rtx-treated patients.2 3 Accordingly, the last EULAR recommendations on vaccination advised that ‘vaccination should be provided at least 6 months after the last administration and 4 weeks before the next course of B cell-depleting therapy’.4 To ensure appropriate SARS-CoV-2 vaccination, the last EULAR advise was to refer to a rheumatologist.5 The American College of Rheumatology (ACR) has recommended to vaccinate Rtx-treated patients not earlier than 5 months after the last administration with the next cycle given not earlier than 2–4 weeks thereafter.6 In any case, the combination of B cell-depleting therapy with vaccination has been quite a challenge for patients and physicians—especially since it became clear that Rtx therapy may be associated with unfavourable outcomes in B cell-depleted patients.7 Fortunately, very recent data by Bonelli et al have now suggested that a cellular response is mounted after SARS-CoV-2 vaccination in Rtx-treated patients despite a failed humoral immune response.1 The authors demonstrated that peripheral blood cells of vaccinated patients do produce Interferon γ (IFNγ) after stimulation with SARS-CoV-2 spike (S) protein-derived overlapping peptides.1 These results increase the scientific interest into a more detailed characterisation of vaccine-reactive T-cell immunity, which has recently been in the focus of our group as well due to a frequent Rtx application in our settings.Applying multiparameter flow cytometry, we explored the … ER -