ABSTRACT
We designed a prospective study to evaluate the humoral (using a surrogate virus neutralization test) and cellular (using an IFN-γ ELISpot) immune response among patients with chronic lymphocytic leukemia (CLL) against Wuhan-Hu-1 and Omicron BA.2 strains of SARS-CoV-2, after mRNA-based vaccination. The proportion of patients with a functional humoral response was higher among untreated CLL patients compared to treated CLL patients against both Wuhan-Hu-1 and Omicron BA.2 after the second and the third dose of vaccination, and at 12 months after the first dose. The proportion of positive cellular response against the peptide pool covering the full-length Wuhan-Hu-1 spike protein was similar between untreated and treated CLL patients at all three timepoints. The cellular response to the mutated regions of BA.2 spike protein was lower than the response to the corresponding regions in the ancestral spike after the second dose, but this difference was eliminated after the third dose.
Subject(s)
COVID-19 , Leukemia, Lymphocytic, Chronic, B-Cell , Humans , COVID-19 Vaccines , SARS-CoV-2 , COVID-19/prevention & control , Leukemia, Lymphocytic, Chronic, B-Cell/genetics , Leukemia, Lymphocytic, Chronic, B-Cell/therapy , Prospective Studies , Spike Glycoprotein, Coronavirus/genetics , Antibodies, ViralSubject(s)
COVID-19 , Vaccines , Humans , COVID-19/therapy , Immunization, Passive , Immunosuppression Therapy , COVID-19 SerotherapySubject(s)
COVID-19/diagnosis , Jaundice/etiology , Liver/pathology , Systemic Inflammatory Response Syndrome/diagnosis , Bone Marrow/pathology , C-Reactive Protein/analysis , COVID-19/complications , Cholestasis/diagnosis , Diagnosis, Differential , Humans , Male , Middle Aged , Pruritus/etiology , Systemic Inflammatory Response Syndrome/complicationsABSTRACT
Standard treatment options in classic HCL (cHCL) result in high response rates and near normal life expectancy. However, the disease itself and the recommended standard treatment are associated with profound and prolonged immunosuppression, increasing susceptibility to infections and the risk for a severe course of COVID-19. The Hairy Cell Leukemia Foundation (HCLF) has recently convened experts and discussed different clinical strategies for the management of these patients. The new recommendations adapt the 2017 consensus for the diagnosis and management with cHCL to the current COVID-19 pandemic. They underline the option of active surveillance in patients with low but stable blood counts, consider the use of targeted and non-immunosuppressive agents as first-line treatment for cHCL, and give recommendations on preventive measures against COVID-19.