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B Cell Aplasia Is the Most Powerful Predictive Marker for Poor Humoral Response after BNT162b2 mRNA SARS-CoV-2 Vaccination in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation.
Jullien, Maxime; Le Bourgeois, Amandine; Coste-Burel, Marianne; Peterlin, Pierre; Garnier, Alice; Rimbert, Marie; Imbert, Berthe-Marie; Le Gouill, Steven; Moreau, Philippe; Mahe, Beatrice; Dubruille, Viviane; Blin, Nicolas; Lok, Anne; Touzeau, Cyrille; Gastinne, Thomas; Tessoulin, Benoit; Vantyghem, Sophie; Béné, Marie C; Guillaume, Thierry; Chevallier, Patrice.
  • Jullien M; Hematology Department, Nantes University Hospital, Nantes, France.
  • Le Bourgeois A; Hematology Department, Nantes University Hospital, Nantes, France.
  • Coste-Burel M; Virology Department, Nantes University Hospital, Nantes, France.
  • Peterlin P; Hematology Department, Nantes University Hospital, Nantes, France.
  • Garnier A; Hematology Department, Nantes University Hospital, Nantes, France.
  • Rimbert M; Immunology Department, Nantes University Hospital, Nantes, France.
  • Imbert BM; Virology Department, Nantes University Hospital, Nantes, France.
  • Le Gouill S; Hematology Department, Nantes University Hospital, Nantes, France.
  • Moreau P; Hematology Department, Nantes University Hospital, Nantes, France.
  • Mahe B; Hematology Department, Nantes University Hospital, Nantes, France.
  • Dubruille V; Hematology Department, Nantes University Hospital, Nantes, France.
  • Blin N; Hematology Department, Nantes University Hospital, Nantes, France.
  • Lok A; Hematology Department, Nantes University Hospital, Nantes, France.
  • Touzeau C; Hematology Department, Nantes University Hospital, Nantes, France.
  • Gastinne T; Hematology Department, Nantes University Hospital, Nantes, France.
  • Tessoulin B; Hematology Department, Nantes University Hospital, Nantes, France.
  • Vantyghem S; Hematology Department, Nantes University Hospital, Nantes, France.
  • Béné MC; INSERM UMR1232, CRCINA IRS-UN, University of Nantes, University Hospital, Nantes, France; Hematology Biology Department, Nantes University Hospital, Nantes, France.
  • Guillaume T; Hematology Department, Nantes University Hospital, Nantes, France; INSERM UMR1232, CRCINA IRS-UN, University of Nantes, University Hospital, Nantes, France.
  • Chevallier P; Hematology Department, Nantes University Hospital, Nantes, France; INSERM UMR1232, CRCINA IRS-UN, University of Nantes, University Hospital, Nantes, France. Electronic address: patrice.chevallier@chu-nantes.fr.
Transplant Cell Ther ; 28(5): 279.e1-279.e4, 2022 05.
Article in English | MEDLINE | ID: covidwho-1763866
ABSTRACT
Little is known about the immune response to SARS-CoV-2 vaccination in recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, several studies have reported that adequate protection could be provided to this population. The purpose of this study was to evaluate which factors can predict the efficacy of SARS-CoV-2 vaccination in these specifically immunosuppressed patients. Specific anti-Spike (S) antibody responses were assessed in a cohort of 117 allo-HSCT recipients after 2 injections of BNT162b2 mRNA SARS-CoV-2 vaccine (V1 and V2). Factors considered liable to influence the antibody response and analyzed in this series were the interval between allo-HSCT and V1, donor source, recipient and donor age, current immunosuppressive/chemotherapy (I/C) treatment, and levels of CD4+and CD8+ T cells, B cells, and natural killer cells at the time of V1. Overall, the S-antibody response rate, evaluated at a median of 35 days after V2, was 82.9% for the entire cohort, with 71 patients (61%) reaching the highest titer. In univariate analysis, a lower pre-V1 median total lymphocyte count, lower CD4+ T cell and B cell counts, ongoing I/C treatment, and a haploidentical donor were characteristic of nonhumoral responders. However, multiparameter analysis showed that B cell aplasia was the sole factor predicting the absence of a specific immune response (odds ratio, 0.01; 95% confidence interval, 0.00 to 0.10; P < 10-3). Indeed, the rate of humoral response was 9.1% in patients with B cell aplasia versus 95.9% in patients with a B cell count >0 (P < 10-9). These results advocate for the administration of anti-SARS-CoV-2 vaccination in allo-HSCT recipients as early as peripheral B cell levels can be detected, and also suggest the need for close monitoring of B-cell reconstitution after Allo-HSCT.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hematopoietic Stem Cell Transplantation / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: Transplant Cell Ther Year: 2022 Document Type: Article Affiliation country: J.jtct.2022.02.018

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hematopoietic Stem Cell Transplantation / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: Transplant Cell Ther Year: 2022 Document Type: Article Affiliation country: J.jtct.2022.02.018