期刊
BRITISH JOURNAL OF HAEMATOLOGY
卷 196, 期 3, 页码 548-558出版社
WILEY
DOI: 10.1111/bjh.17877
关键词
COVID-19; lymphoid malignancies; T-cell immune response; Seroconversion; anti-CD20 antibody
类别
资金
- Ministero della Salute (Ricerca Corrente -Linea 1)
- Associazione Italiana Leucemie (AIL Milano)
- Universita degli Studi diMilano within the CRUI-CARE Agreement
The study evaluated the serological and T-cell responses of lymphoid malignancy patients after mRNA vaccination, finding that some patients, especially those receiving anti-CD20 antibody treatment, may not effectively develop protective antibodies. T-cell responses were detected in most patients, even in seronegative individuals, but a small percentage of cases had no cellular or humoral responses. This raises concerns about the vaccine efficacy for LM patients, highlighting the need for continued protective measures.
Patients affected by lymphoid malignancies (LM) are frequently immune-compromised, suffering increased mortality from COVID-19. This prospective study evaluated serological and T-cell responses after complete mRNA vaccination in 263 patients affected by chronic lymphocytic leukaemia, B- and T-cell lymphomas and multiple myeloma. Results were compared with those of 167 healthy subjects matched for age and sex. Overall, patient seroconversion rate was 64 center dot 6%: serological response was lower in those receiving anti-cancer treatments in the 12 months before vaccination: 55% vs 81 center dot 9% (P < 0 center dot 001). Anti-CD20 antibody plus chemotherapy treatment was associated with the lowest seroconversion rate: 17 center dot 6% vs. 71 center dot 2% (P < 0 center dot 001). In the multivariate analysis conducted in the subgroup of patients on active treatment, independent predictors for seroconversion were: anti-CD20 treatment (P < 0 center dot 001), aggressive B-cell lymphoma diagnosis (P = 0 center dot 002), and immunoglobulin M levels <40 mg/dl (P = 0 center dot 030). The T-cell response was evaluated in 99 patients and detected in 85 of them (86%). Of note, 74% of seronegative patients had a T-cell response, but both cellular and humoral responses were absent in 13 center dot 1% of cases. Our findings raise some concerns about the protection that patients with LM, particularly those receiving anti-CD20 antibodies, may gain from vaccination. These patients should strictly maintain all the protective measures.
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