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Definition of factors associated with negative antibody response after COVID-19 vaccination in patients with hematological diseases.
Rotterdam, Jil; Thiaucourt, Margot; Weiss, Christel; Schwaab, Juliana; Reiter, Andreas; Kreil, Sebastian; Steiner, Laurenz; Fenchel, Sebastian; Popp, Henning D; Hofmann, Wolf-Karsten; Bonatz, Karin; Gerhards, Catharina; Neumaier, Michael; Klein, Stefan A; Rao, Sonika; Jawhar, Mohamad; Saussele, Susanne.
  • Rotterdam J; Department of Hematology and Oncology, III. Medical Clinic, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
  • Thiaucourt M; Institute for Clinical Chemistry, University Hospital Mannheim, Heidelberg University, Mannheim, Germany.
  • Weiss C; Department of Medical Statistics, Biomathematics and Information Processing, Center for Preventive Medicine and Digital Health Baden-Württemberg (CPD-BW), University Hospital Mannheim, Heidelberg University, Mannheim, Germany.
  • Schwaab J; Department of Hematology and Oncology, III. Medical Clinic, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
  • Reiter A; Department of Hematology and Oncology, III. Medical Clinic, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
  • Kreil S; Department of Hematology and Oncology, III. Medical Clinic, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
  • Steiner L; Department of Hematology and Oncology, III. Medical Clinic, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
  • Fenchel S; Department of Hematology and Oncology, III. Medical Clinic, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
  • Popp HD; Department of Hematology and Oncology, III. Medical Clinic, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
  • Hofmann WK; Department of Hematology and Oncology, III. Medical Clinic, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
  • Bonatz K; Department of Hematology and Oncology, III. Medical Clinic, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
  • Gerhards C; Institute for Clinical Chemistry, University Hospital Mannheim, Heidelberg University, Mannheim, Germany.
  • Neumaier M; Institute for Clinical Chemistry, University Hospital Mannheim, Heidelberg University, Mannheim, Germany.
  • Klein SA; Department of Hematology and Oncology, III. Medical Clinic, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
  • Rao S; Institute for Clinical Chemistry, University Hospital Mannheim, Heidelberg University, Mannheim, Germany.
  • Jawhar M; Department of Hematology and Oncology, III. Medical Clinic, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
  • Saussele S; Department of Hematology and Oncology, III. Medical Clinic, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. Susanne.Saussele@medma.uni-heidelberg.de.
Ann Hematol ; 101(8): 1825-1834, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1858973
ABSTRACT
COVID-19 in patients with hematological diseases is associated with a high mortality. Moreover, preventive vaccination demonstrated reduced efficacy and the knowledge on influencing factors is limited. In this single-center study, antibody levels of the SARS-CoV-2 spike protein were measured ≥ 2 weeks after 2nd COVID-19 vaccination with a concentration ≥ 0.8 U/mL considered positive. Between July and October 2021, in a total of 373 patients (median age 64 years, 44% women) with myeloid neoplasms (n = 214, 57%), lymphoid neoplasms (n = 124, n = 33%), and other diseases (n = 35, 10%), vaccination was performed with BNT162b2 (BioNTech), mRNA-1273 (Moderna), ChADOx1 (AstraZeneca), or a combination. A total of 229 patients (61%) were on active therapy within 3 months prior vaccination and 144 patients (39%) were previously treated or treatment naïve. Vaccination-related antibody response was negative in 56/373 patients (15%) in 39/124 patients with lymphoid neoplasms, 13/214 with myeloid neoplasms, and 4/35 with other diseases. Active treatment per se was not correlated with negative response. However, rituximab and BTK inhibitor treatment were correlated significantly with a negative vaccination response, whereas younger age and chronic myeloid leukemia (CML) disease were associated with positive response. In addition, 5 of 6 patients with myeloproliferative neoplasm (MPN) and negative vaccination response were on active treatment with ruxolitinib. In conclusion, a remarkable percentage of patients with hematological diseases had no response after 2nd COVID-19 vaccination. Multivariable analysis revealed important factors associated with response to vaccination. The results may serve as a guide for better protection and surveillance in this vulnerable patient cohort.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / COVID-19 / Hematologic Diseases / Antibody Formation Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Female / Humans / Male / Middle aged Language: English Journal: Ann Hematol Journal subject: Hematology Year: 2022 Document Type: Article Affiliation country: S00277-022-04866-z

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / COVID-19 / Hematologic Diseases / Antibody Formation Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Female / Humans / Male / Middle aged Language: English Journal: Ann Hematol Journal subject: Hematology Year: 2022 Document Type: Article Affiliation country: S00277-022-04866-z