Humoral Immunity After COVID-19 Vaccination in Chronic Lymphocytic Leukemia and Other Indolent Lymphomas: A Single-Center Observational Study.

BACKGROUND: Chronic lymphocytic leukemia (CLL) and other non-Hodgkin's lymphomas (NHLs) lead to broad immunosuppression, conferring a greater risk for morbidity and mortality from SARS-CoV-2. Our study analyzed antibody (Ab) seropositivity from SARS-CoV-2 vaccination in patients with these cancers. METHODS: In the final analysis, 240 patients were involved, and seropositivity was defined as a positive total or spike protein Ab. RESULTS: Seropositivity was 50% in CLL, 68% in WM, and 70% in the remaining NHLs. Moderna vaccination led to higher seropositivity compared to Pfizer vaccination across all cancers (64% vs. 49%; P = .022) and specifically CLL patients (59% vs. 43%; P = .029). This difference was not explainable by differences in treatment status or prior anti-CD20 monoclonal Ab therapy. In CLL patients, current or prior cancer therapy led to lower seropositivity compared to treatment-naïve patients (36% vs. 68%; P = .000019). CLL patients treated with Bruton's tyrosine kinase (BTK) inhibitors had better seropositivity after receiving the Moderna vaccination compared to Pfizer (50% vs. 23%; P = .015). Across all cancers, anti-CD20 agents within 1 year led to a lower Ab response compared to greater than one year (13% vs. 40%; P = .022), a difference which persisted after booster vaccination. CONCLUSION: Antibody response is lower in patients with indolent lymphomas compared to the general population. Lower Ab seropositivity was found in patients with a history of anti-leukemic agent therapy or those immunized with Pfizer vaccine. This data suggests that Moderna vaccination may confer a greater degree of immunity against SARS-CoV-2 in patients with indolent lymphomas.

Attention attenuates metacontrast masking.

The influence of attention on perceptual awareness was examined using metacontrast masking. Attention was manipulated with endogenous cues to assess the effects on the temporal and spatial parameters of target visibility. Experiment 1 examined the time course of effective masking when the target and mask set were presented at an attended vs. an unattended location. The valid allocation of attention decreased the magnitude of the masking effect (i.e. increased visibility) for approximately 80 ms. Furthermore, even with spatial displacements of the target and mask and center-to-center separations of 1.5 degrees or 2.7 degrees of visual angle (Experiment 2), target visibility was increased when attention was validly allocated. These results indicate that attention influences low-level visual processes to enhance visual awareness.

Unconscious processing of orientation and color without primary visual cortex.

In humans, the primary visual cortex (V1) is essential for conscious vision. However, even without V1 and in the absence of awareness, some preserved ability to accurately respond to visual inputs has been demonstrated, a phenomenon referred to as blindsight. We used transcranial magnetic stimulation (TMS) to deactivate V1, producing transient blindness for visual targets presented in a foveal, TMS-induced scotoma. Despite unawareness of these targets, performance on forced choice discrimination tasks for orientation (experiment 1) and color (experiment 2) were both significantly above chance. In addition to demonstrating that TMS can be successfully used to induce blindsight within a normal population, these results suggest a functioning geniculoextrastriate visual pathway that bypasses V1 and can process orientation and color in the absence of conscious awareness.