tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2022 Aug 16;9(8)
fac417.
doi: 10.1093/ofid/ofac417. eCollection 2022 Aug.
Immunogenicity of a Three-Dose Primary Series of mRNA COVID-19 Vaccines in Patients With Lymphoid Malignancies
Amy C Sherman[SUP] 1 2 3 4 [/SUP], Jennifer L Crombie[SUP] 2 4 [/SUP], ChiAn Cheng[SUP] 4 5 6 7 [/SUP], Michaël Desjardins[SUP] 1 8 [/SUP], Guohai Zhou[SUP] 1 [/SUP], Omolola Ometoruwa[SUP] 1 [/SUP], Rebecca Rooks[SUP] 1 [/SUP], Yasmeen Senussi[SUP] 4 5 6 [/SUP], Mikaela McDonough[SUP] 2 [/SUP], Liliana I Guerrero[SUP] 2 [/SUP], John Kupelian[SUP] 1 [/SUP], Simon Doss-Gollin[SUP] 3 [/SUP], Kinga K Smolen[SUP] 3 4 [/SUP], Simon D van Haren[SUP] 3 4 [/SUP], Philippe Armand[SUP] 2 4 [/SUP], Ofer Levy[SUP] 3 4 9 [/SUP], David R Walt[SUP] 4 5 6 [/SUP], Lindsey R Baden[SUP] 1 2 4 [/SUP], Nicolas C Issa[SUP] 1 2 4 [/SUP]
Affiliations
Abstract
Background: Patients with lymphoid malignancies are at risk for poor coronavirus disease 2019 (COVID-19)-related outcomes and have reduced vaccine-induced immune responses. Currently, a 3-dose primary regimen of mRNA vaccines is recommended in the United States for immunocompromised hosts.
Methods: A prospective cohort study of healthy adults (n = 27) and patients with lymphoid malignancies (n = 94) was conducted, with longitudinal follow-up through completion of a 2- or 3-dose primary mRNA COVID vaccine series, respectively. Humoral responses were assessed in all participants, and cellular immunity was assessed in a subset of participants.
Results: The rate of seroconversion (68.1% vs 100%) and the magnitude of peak anti-S immunoglobulin G (IgG) titer (median anti-S IgG = 32.4, IQR = 0.48-75.0 vs median anti-S IgG = 72.6, IQR 51.1-100.1; P = .0202) were both significantly lower in patients with lymphoid malignancies compared to the healthy cohort. However, peak titers of patients with lymphoid malignancies who responded to vaccination were similar to healthy cohort titers (median anti-S IgG = 64.3; IQR, 23.7-161.5; P = .7424). The third dose seroconverted 7 of 41 (17.1%) patients who were seronegative after the first 2 doses. Although most patients with lymphoid malignancies produced vaccine-induced T-cell responses in the subset studied, B-cell frequencies were low with minimal memory cell formation.
Conclusions: A 3-dose primary mRNA series enhanced anti-S IgG responses to titers equivalent to healthy adults in patients with lymphoid malignancies who were seropositive after the first 2 doses and seroconverted 17.1% who were seronegative after the first 2 doses. T-cell responses were present, raising the possibility that the vaccines may confer some cell-based protection even if not measurable by anti-S IgG.
Keywords: SARS-CoV-2; lymphoid malignancies; mRNA vaccines; primary series.
. 2022 Aug 16;9(8)
fac417.doi: 10.1093/ofid/ofac417. eCollection 2022 Aug.
Immunogenicity of a Three-Dose Primary Series of mRNA COVID-19 Vaccines in Patients With Lymphoid Malignancies
Amy C Sherman[SUP] 1 2 3 4 [/SUP], Jennifer L Crombie[SUP] 2 4 [/SUP], ChiAn Cheng[SUP] 4 5 6 7 [/SUP], Michaël Desjardins[SUP] 1 8 [/SUP], Guohai Zhou[SUP] 1 [/SUP], Omolola Ometoruwa[SUP] 1 [/SUP], Rebecca Rooks[SUP] 1 [/SUP], Yasmeen Senussi[SUP] 4 5 6 [/SUP], Mikaela McDonough[SUP] 2 [/SUP], Liliana I Guerrero[SUP] 2 [/SUP], John Kupelian[SUP] 1 [/SUP], Simon Doss-Gollin[SUP] 3 [/SUP], Kinga K Smolen[SUP] 3 4 [/SUP], Simon D van Haren[SUP] 3 4 [/SUP], Philippe Armand[SUP] 2 4 [/SUP], Ofer Levy[SUP] 3 4 9 [/SUP], David R Walt[SUP] 4 5 6 [/SUP], Lindsey R Baden[SUP] 1 2 4 [/SUP], Nicolas C Issa[SUP] 1 2 4 [/SUP]
Affiliations
- PMID: 36043177
- PMCID: PMC9384786
- DOI: 10.1093/ofid/ofac417
Abstract
Background: Patients with lymphoid malignancies are at risk for poor coronavirus disease 2019 (COVID-19)-related outcomes and have reduced vaccine-induced immune responses. Currently, a 3-dose primary regimen of mRNA vaccines is recommended in the United States for immunocompromised hosts.
Methods: A prospective cohort study of healthy adults (n = 27) and patients with lymphoid malignancies (n = 94) was conducted, with longitudinal follow-up through completion of a 2- or 3-dose primary mRNA COVID vaccine series, respectively. Humoral responses were assessed in all participants, and cellular immunity was assessed in a subset of participants.
Results: The rate of seroconversion (68.1% vs 100%) and the magnitude of peak anti-S immunoglobulin G (IgG) titer (median anti-S IgG = 32.4, IQR = 0.48-75.0 vs median anti-S IgG = 72.6, IQR 51.1-100.1; P = .0202) were both significantly lower in patients with lymphoid malignancies compared to the healthy cohort. However, peak titers of patients with lymphoid malignancies who responded to vaccination were similar to healthy cohort titers (median anti-S IgG = 64.3; IQR, 23.7-161.5; P = .7424). The third dose seroconverted 7 of 41 (17.1%) patients who were seronegative after the first 2 doses. Although most patients with lymphoid malignancies produced vaccine-induced T-cell responses in the subset studied, B-cell frequencies were low with minimal memory cell formation.
Conclusions: A 3-dose primary mRNA series enhanced anti-S IgG responses to titers equivalent to healthy adults in patients with lymphoid malignancies who were seropositive after the first 2 doses and seroconverted 17.1% who were seronegative after the first 2 doses. T-cell responses were present, raising the possibility that the vaccines may confer some cell-based protection even if not measurable by anti-S IgG.
Keywords: SARS-CoV-2; lymphoid malignancies; mRNA vaccines; primary series.