Tough read, but if I understand correctly,
-Patients responding to Rituximab may have autoantibody production from immature plasma cells (plasmablasts).
-This study suggests patients with autoantibody-production from the mature plasma cells, not responding to Rituximab, may be helped with a possible treatment using a regimen that targets mature plasma cells.
-They suggest the above is why Rituximab had limited results in a recent study.
-In short, the theory is to go after CFS first with an inhibitory or cytotoxic agent. And then combine or follow with a B-cell depletion medication such as Rituximab.
-Cyclophosphamide was mentioned as it targets CD4 and CD8 T-cells as well as B-cell proliferation. Cyclophosphamide is currently used in cancer patients.
-Interestingly, Cyclophosphamide is mentioned in "Multitasking Biomolecules in ME/CFS Pathogenesis - Alain Moreau - OMF Working Group Meeting September 8-11, 2020" which is a separate thread. In that presentation, they discussed Cyclophosphamide as reducing TSP-1 (Thrombospondin) levels.
-At the very end of the paper, they give specific examples of patients who improved and the drugs involved.
No promises on the accuracy of the above as I am in over my head with this subject.