T-cell immune response after mRNA SARS-CoV-2 vaccines is frequently detected also in the absence of seroconversion in patients with lymphoid malignancies.
Br J Haematol
; 196(3): 548-558, 2022 02.
Article
in English
| MEDLINE | ID: covidwho-1467542
ABSTRACT
Patients affected by lymphoid malignancies (LM) are frequently immune-compromised, suffering increased mortality from COVID-19. This prospective study evaluated serological and T-cell responses after complete mRNA vaccination in 263 patients affected by chronic lymphocytic leukaemia, B- and T-cell lymphomas and multiple myeloma. Results were compared with those of 167 healthy subjects matched for age and sex. Overall, patient seroconversion rate was 64·6% serological response was lower in those receiving anti-cancer treatments in the 12 months before vaccination 55% vs 81·9% (P < 0·001). Anti-CD20 antibody plus chemotherapy treatment was associated with the lowest seroconversion rate 17·6% vs. 71·2% (P < 0·001). In the multivariate analysis conducted in the subgroup of patients on active treatment, independent predictors for seroconversion were anti-CD20 treatment (P < 0·001), aggressive B-cell lymphoma diagnosis (P = 0·002), and immunoglobulin M levels <40 mg/dl (P = 0·030). The T-cell response was evaluated in 99 patients and detected in 85 of them (86%). Of note, 74% of seronegative patients had a T-cell response, but both cellular and humoral responses were absent in 13·1% of cases. Our findings raise some concerns about the protection that patients with LM, particularly those receiving anti-CD20 antibodies, may gain from vaccination. These patients should strictly maintain all the protective measures.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
T-Lymphocytes
/
Antineoplastic Combined Chemotherapy Protocols
/
Hematologic Neoplasms
/
SARS-CoV-2
/
COVID-19
/
BNT162 Vaccine
/
2019-nCoV Vaccine mRNA-1273
/
Immunity, Cellular
/
Lymphoproliferative Disorders
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Vaccines
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Br J Haematol
Year:
2022
Document Type:
Article
Affiliation country:
Bjh.17877
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