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Jpn J Clin Oncol . Humoral and T-cell immune responses to coronavirus disease 2019 vaccines in patients with hematological malignancies

tetano

Editor, Senior Moderator
Jpn J Clin Oncol


. 2025 Dec 29:hyaf207.
doi: 10.1093/jjco/hyaf207. Online ahead of print. Humoral and T-cell immune responses to coronavirus disease 2019 vaccines in patients with hematological malignancies

Haruhi Makino[SUP] 1 2 [/SUP], Suguru Fukuhara[SUP] 1 [/SUP], Keiji Okinaka[SUP] 3 [/SUP], Maki Shibata[SUP] 1 [/SUP], Daiki Hattori[SUP] 1 [/SUP], Hirokazu Sasaki[SUP] 1 [/SUP], Shinichi Makita[SUP] 1 [/SUP], Noriko Iwaki[SUP] 1 [/SUP], Wataru Munakata[SUP] 1 [/SUP], Shigehiro Yagishita[SUP] 4 [/SUP], Mika Shiotsuka[SUP] 5 [/SUP], Osamu Kobayashi[SUP] 5 [/SUP], Masatoshi Yanagida[SUP] 6 [/SUP], Yasuhiro Irino[SUP] 6 [/SUP], Akinobu Hamada[SUP] 4 [/SUP], Noboru Yamamoto[SUP] 7 [/SUP], Yasushi Goto[SUP] 2 [/SUP], Koji Izutsu[SUP] 1 [/SUP], Yuki Katsuya[SUP] 7 [/SUP]



Affiliations
Abstract

Background: Recent studies have demonstrated that patients with hematological malignancies (HM) exhibit significantly impaired humoral immune responses after coronavirus disease 2019 (COVID-19) vaccination. Although booster doses and cellular immune responses have been increasingly studied, few analyses have concurrently evaluated both humoral and cellular immunity in patients receiving bendamustine, bispecific antibodies, or CAR-T therapies. We aimed to assess the humoral immunogenicity, T-cell immune response, and booster effect after COVID-19 vaccination in patients with B-cell lymphoma undergoing immunochemotherapy or novel agent treatment.
Methods: Serum antibodies to the severe acute respiratory syndrome coronavirus 2 spike protein (S-IgG) were measured after the second and booster (third) mRNA vaccinations, and specific T-cell responses were measured using the enzyme-linked immunosorbent spot method.
Results: Forty-six of 114 patients (40%) acquired antibodies. Age < 65 years (odds ratio 8.99) and CD19 ≥ 50/μL (odds ratio 19.7) were independent predictors of response. To support the selection of this threshold, operating characteristic curve analysis was performed and confirmed CD19 ≥ 50/μL as a clinically meaningful discriminator despite a lower statistical cutoff. Even in some patients who did not develop antibodies, T-cell responses were observed (36% after two doses; 45.5% after the booster). The booster vaccine enhanced antibody (40% to 62.9%) and T-cell (47.2% to 57.6%) responses.
Conclusions: This study provides confirmatory real-world evidence that CD19 recovery is a key determinant of humoral response, while vaccine-induced T-cell immunity may be preserved even in antibody-nonresponders, supporting continued vaccination efforts in this high-risk population.

Keywords: B-cell lymphoma; SARS-CoV-2; hematologic neoplasms; mRNA vaccine; vaccination.

 
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