Details

Autor(en) / Beteiligte

• Haggenburg, Sabine
• Lissenberg-Witte, Birgit I.
• van Binnendijk, Rob S.
• den Hartog, Gerco
• Bhoekhan, Michel S.
• Haverkate, Nienke J.E.
• de Rooij, Dennis M.
• van Meerloo, Johan
• Cloos, Jacqueline
• Kootstra, Neeltje A.
• Wouters, Dorine
• Weijers, Suzanne S.
• van Leeuwen, Ester M.M.
• Bontkes, Hetty J.
• Tonouh-Aajoud, Saïda
• Heemskerk, Mirjam H.M.
• Sanders, Rogier W.
• Roelandse-Koop, Elianne
• Hofsink, Quincy
• Groen, Kazimierz
• Çetinel, Lucia
• Schellekens, Louis
• den Hartog, Yvonne M.
• Toussaint, Belle
• Kant, Iris M.J.
• Graas, Thecla
• de Pater, Emma
• Dik, Willem A.
• Engel, Marije D.
• Pierie, Cheyenne R.N.
• Janssen, Suzanne R.
• van Dijkman, Edith
• Poniman, Meliawati
• Burger, Judith A.
• Bouhuijs, Joey H.
• Smits, Gaby
• Rots, Nynke Y.
• Zweegman, Sonja
• Kater, Arnon P.
• van Meerten, Tom
• Mutsaers, Pim G.N.J.
• van Doesum, Jaap A.
• Broers, Annoek E.C.
• van Gils, Marit J.
• Goorhuis, Abraham
• Rutten, Caroline E.
• Hazenberg, Mette D.
• Nijhof, Inger S.

Titel

Quantitative analysis of mRNA-1273 COVID-19 vaccination response in immunocompromised adult hematology patients

Ist Teil von

• Blood advances, 2022-03, Vol.6 (5), p.1537-1546

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2022

Quelle

MEDLINE

Beschreibungen/Notizen

• Vaccination guidelines for patients treated for hematological diseases are typically conservative. Given their high risk for severe COVID-19, it is important to identify those patients that benefit from vaccination. We prospectively quantified serum immunoglobulin G (IgG) antibodies to spike subunit 1 (S1) antigens during and after 2-dose mRNA-1273 (Spikevax/Moderna) vaccination in hematology patients. Obtaining S1 IgG ≥ 300 binding antibody units (BAUs)/mL was considered adequate as it represents the lower level of S1 IgG concentration obtained in healthy individuals, and it correlates with potent virus neutralization. Selected patients (n = 723) were severely immunocompromised owing to their disease or treatment thereof. Nevertheless, >50% of patients obtained S1 IgG ≥ 300 BAUs/mL after 2-dose mRNA-1273. All patients with sickle cell disease or chronic myeloid leukemia obtained adequate antibody concentrations. Around 70% of patients with chronic graft-versus-host disease (cGVHD), multiple myeloma, or untreated chronic lymphocytic leukemia (CLL) obtained S1 IgG ≥ 300 BAUs/mL. Ruxolitinib or hypomethylating therapy but not high-dose chemotherapy blunted responses in myeloid malignancies. Responses in patients with lymphoma, patients with CLL on ibrutinib, and chimeric antigen receptor T-cell recipients were low. The minimal time interval after autologous hematopoietic cell transplantation (HCT) to reach adequate concentrations was <2 months for multiple myeloma, 8 months for lymphoma, and 4 to 6 months after allogeneic HCT. Serum IgG4, absolute B- and natural killer–cell number, and number of immunosuppressants predicted S1 IgG ≥ 300 BAUs/mL. Hematology patients on chemotherapy, shortly after HCT, or with cGVHD should not be precluded from vaccination. This trial was registered at Netherlands Trial Register as #NL9553. •Immunochemotherapy does not preclude adequate antibody responses in hematology patients, except when B cells are absent or dysfunctional.•During the pandemic, COVID-19 vaccination should not be delayed in hematology patients. [Display omitted]