TY - JOUR
T1 - Cellular and humoral immunogenicity of the mRNA-1273 SARS-CoV-2 vaccine in patients with hematologic malignancies
AU - Jiménez, Moraima
AU - Roldán Galvan, Elisa
AU - Fernandez-Naval, Candela
AU - Villacampa Javierre, Guillermo
AU - Martinez-Gallo, Mónica
AU - Medina-Gil, Daniel
AU - Peralta-Garzón, Soraya
AU - Pujadas, Gemma
AU - Hernández, Cristina
AU - Pagès-Portabella, Carlota
AU - Gironella, Mercedes
AU - Fox, Maria Laura
AU - Orti, Guillermo
AU - Barba, Pere
AU - Pumarola Suñé, Tomàs
AU - Cabirta, Alba
AU - Catalá, Eva
AU - Valentín, Mercedes
AU - Marín-Niebla, Ana
AU - Orfao, Alberto
AU - González, Marcos
AU - Campins Martí, Magda
AU - Ruiz-Camps, Isabel
AU - Valcárcel, David
AU - Bosch José, Francesc Xavier
AU - Hernández, Manuel
AU - Crespo, Marta
AU - Esperalba, Juliana
AU - Abrisqueta, Pau
PY - 2021
Y1 - 2021
N2 - Recent studies have shown a suboptimal humoral response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in patients diagnosed with hematologic malignancies; however, data about cellular immunogenicity are scarce. The aim of this study was to evaluate both the humoral and cellular immunogenicity 1 month after the second dose of the mRNA-1273 vaccine. Antibody titers were measured by using the Elecsys and LIAISON anti-SARS-CoV-2 S assays, and T-cell response was assessed by using interferon-γ release immunoassay technology. Overall, 76.3% (184 of 241) of patients developed humoral immunity, and the cellular response rate was 79% (184 of 233). Hypogammaglobulinemia, lymphopenia, active hematologic treatment, and anti-CD20 therapy during the previous 6 months were associated with an inferior humoral response. Conversely, age >65 years, active disease, lymphopenia, and immunosuppressive treatment of graft-versus-host disease (GVHD) were associated with an impaired cellular response. A significant dissociation between the humoral and cellular responses was observed in patients treated with anti-CD20 therapy (the humoral response was 17.5%, whereas the cellular response was 71.1%). In these patients, B-cell aplasia was confirmed while T-cell counts were preserved. In contrast, humoral response was observed in 77.3% of patients undergoing immunosuppressive treatment of GVHD, whereas only 52.4% had a cellular response. The cellular and humoral responses to the SARS-CoV-2 mRNA-1273 vaccine in patients with hematologic malignancies are highly influenced by the presence of treatments such as anti-CD20 therapy and immunosuppressive agents. This observation has implications for the further management of these patients.
AB - Recent studies have shown a suboptimal humoral response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in patients diagnosed with hematologic malignancies; however, data about cellular immunogenicity are scarce. The aim of this study was to evaluate both the humoral and cellular immunogenicity 1 month after the second dose of the mRNA-1273 vaccine. Antibody titers were measured by using the Elecsys and LIAISON anti-SARS-CoV-2 S assays, and T-cell response was assessed by using interferon-γ release immunoassay technology. Overall, 76.3% (184 of 241) of patients developed humoral immunity, and the cellular response rate was 79% (184 of 233). Hypogammaglobulinemia, lymphopenia, active hematologic treatment, and anti-CD20 therapy during the previous 6 months were associated with an inferior humoral response. Conversely, age >65 years, active disease, lymphopenia, and immunosuppressive treatment of graft-versus-host disease (GVHD) were associated with an impaired cellular response. A significant dissociation between the humoral and cellular responses was observed in patients treated with anti-CD20 therapy (the humoral response was 17.5%, whereas the cellular response was 71.1%). In these patients, B-cell aplasia was confirmed while T-cell counts were preserved. In contrast, humoral response was observed in 77.3% of patients undergoing immunosuppressive treatment of GVHD, whereas only 52.4% had a cellular response. The cellular and humoral responses to the SARS-CoV-2 mRNA-1273 vaccine in patients with hematologic malignancies are highly influenced by the presence of treatments such as anti-CD20 therapy and immunosuppressive agents. This observation has implications for the further management of these patients.
U2 - 10.1182/bloodadvances.2021006101
DO - 10.1182/bloodadvances.2021006101
M3 - Article
C2 - 34844263
SN - 2473-9537
VL - 6
SP - 774
EP - 784
JO - Blood advances
JF - Blood advances
ER -
