TY - JOUR
T1 - Diminished humoral and cellular responses to SARS-CoV-2 vaccines in patients with chronic lymphocytic leukemia
AU - Ujjani, Chaitra
AU - Gooley, Ted A.
AU - Spurgeon, Stephen E.
AU - Stephens, Deborah M.
AU - Lai, Catherine
AU - Broome, Catherine M.
AU - O Brien, Susan
AU - Zhu, Haiying
AU - Laing, Kerry J.
AU - Winter, Allison M.
AU - Pongas, Georgios
AU - Greninger, Alexander L.
AU - Koelle, David M.
AU - Siddiqi, Tanya
AU - Davids, Matthew S.
AU - Rogers, Kerry A.
AU - Danilov, Alexey V.
AU - Sperling, Amy
AU - Tu, Brian
AU - Sorensen, Tyler
AU - Launchbury, Kelsey
AU - Burrow, Carlissa J.
AU - Quezada, Genesis
AU - Hill, Joshua A.
AU - Shadman, Mazyar
AU - Thompson, Philip A.
N1 - Publisher Copyright:
© 2023 American Society of Hematology. All rights reserved.
PY - 2023/9/12
Y1 - 2023/9/12
N2 - Previous studies have demonstrated low rates of seroconversion to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in patients with chronic lymphocytic leukemia (CLL). In this national collaboration of 11 cancer centers in the United States, we aimed to further characterize and understand vaccine-induced immune responses, including T-cell responses, and the impact of CLL therapeutics (#NCT04852822). Eligible patients were enrolled in 2 cohorts (1) at the time of initial vaccination and (2) at the time of booster vaccination. The serologic response rates (anti-S) from 210 patients in the initial vaccination cohort and 117 in the booster vaccination cohort were 56% (95% confidence interval [CI], 50-63) and 68% (95% CI, 60-77), respectively. Compared with patients not on therapy, those receiving B-cell-directed therapy were less likely to seroconvert (odds ratio [OR], 0.27; 95% CI, 0.15-0.49). Persistence of response was observed at 6 months; anti-S titers increased with the administration of booster vaccinations. In the initial vaccination cohort, positive correlations were observed between the quantitative serologic response and CD4 T-cell response for the Wuhan variant and, to a lesser degree, for the Omicron variant (Spearman P = 0.45 Wuhan; P = 0.25 Omicron). In the booster vaccination cohort, positive correlations were observed between serologic responses and CD4 T-cell responses for both variants (P = 0.58 Wuhan; P = 0.57 Omicron) and to a lesser degree for CD8 T-cell responses (P = 0.33 Wuhan; P = 0.22 Omicron). Although no deaths from coronavirus disease 2019 (COVID-19) have been reported after booster vaccinations, patients should use caution as newer variants emerge and escape vaccineinduced immunity.
AB - Previous studies have demonstrated low rates of seroconversion to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in patients with chronic lymphocytic leukemia (CLL). In this national collaboration of 11 cancer centers in the United States, we aimed to further characterize and understand vaccine-induced immune responses, including T-cell responses, and the impact of CLL therapeutics (#NCT04852822). Eligible patients were enrolled in 2 cohorts (1) at the time of initial vaccination and (2) at the time of booster vaccination. The serologic response rates (anti-S) from 210 patients in the initial vaccination cohort and 117 in the booster vaccination cohort were 56% (95% confidence interval [CI], 50-63) and 68% (95% CI, 60-77), respectively. Compared with patients not on therapy, those receiving B-cell-directed therapy were less likely to seroconvert (odds ratio [OR], 0.27; 95% CI, 0.15-0.49). Persistence of response was observed at 6 months; anti-S titers increased with the administration of booster vaccinations. In the initial vaccination cohort, positive correlations were observed between the quantitative serologic response and CD4 T-cell response for the Wuhan variant and, to a lesser degree, for the Omicron variant (Spearman P = 0.45 Wuhan; P = 0.25 Omicron). In the booster vaccination cohort, positive correlations were observed between serologic responses and CD4 T-cell responses for both variants (P = 0.58 Wuhan; P = 0.57 Omicron) and to a lesser degree for CD8 T-cell responses (P = 0.33 Wuhan; P = 0.22 Omicron). Although no deaths from coronavirus disease 2019 (COVID-19) have been reported after booster vaccinations, patients should use caution as newer variants emerge and escape vaccineinduced immunity.
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U2 - 10.1182/bloodadvances.2022009164
DO - 10.1182/bloodadvances.2022009164
M3 - Article
C2 - 36516082
AN - SCOPUS:85171543615
SN - 2473-9529
VL - 7
SP - 4728
EP - 4737
JO - Blood Advances
JF - Blood Advances
IS - 17
ER -