tetano
Editor, Senior Moderator
Blood Adv
. 2022 Feb 3;bloodadvances.2021006917.
doi: 10.1182/bloodadvances.2021006917. Online ahead of print.
Quantitative analysis of mRNA-1273 COVID-19 vaccination response in immunocompromised adult hematology patients
Sabine Haggenburg[SUP] 1 [/SUP], Birgit I Lissenberg-Witte[SUP] 2 [/SUP], Rob S Van BInnendijk[SUP] 3 [/SUP], Gerco Den Hartog[SUP] 3 [/SUP], Michel S Bhoekhan[SUP] 1 [/SUP], Nienke J E Haverkate[SUP] 1 [/SUP], Dennis Michel De Rooij[SUP] 1 [/SUP], Johan van Meerloo[SUP] 4 [/SUP], Jacqueline Cloos[SUP] 4 [/SUP], Neeltje A Kootstra[SUP] 1 [/SUP], Dorine Wouters[SUP] 1 [/SUP], Suzanne S Weijers[SUP] 1 [/SUP], Ester M M van Leeuwen[SUP] 1 [/SUP], Hetty J Bontkes[SUP] 5 [/SUP], Saida Tonouh-Aajoud[SUP] 1 [/SUP], Mirjam H M Heemskerk[SUP] 6 [/SUP], Rogier Sanders[SUP] 7 [/SUP], Elianne Roelandse-Koop[SUP] 1 [/SUP], Quincy Hofsink[SUP] 1 [/SUP], Kazimierz Groen[SUP] 1 [/SUP], Lusia A Çetinel[SUP] 1 [/SUP], Louis Schellekens[SUP] 1 [/SUP], Yvonne M den Hartog[SUP] 1 [/SUP], Belle Toussaint[SUP] 1 [/SUP], Iris M J Kant[SUP] 1 [/SUP], Thecla Margaretha Graas/Bouman[SUP] 1 [/SUP], Emma de Pater[SUP] 8 [/SUP], Willem Arnout Dik[SUP] 9 [/SUP], Marije D Engel[SUP] 1 [/SUP], Cheyenne R N Pierie[SUP] 1 [/SUP], Susanne R Janssen[SUP] 1 [/SUP], Meliawati Poniman[SUP] 1 [/SUP], Judith A Burger[SUP] 1 [/SUP], Joey H Bouhuijs[SUP] 1 [/SUP], Gaby Smits[SUP] 3 [/SUP], Nynke Y Rots[SUP] 3 [/SUP], Sonja Zweegman[SUP] 10 [/SUP], A P Kater[SUP] 11 [/SUP], Tom van Meerten[SUP] 12 [/SUP], Pim G N J Mutsaers[SUP] 13 [/SUP], Jaap van Doesum[SUP] 14 [/SUP], Annoek E C Broers[SUP] 9 [/SUP], Marit van Gils[SUP] 1 [/SUP], Abraham Goorhuis[SUP] 1 [/SUP], Caroline Rutten[SUP] 1 [/SUP], Mette D Hazenberg[SUP] 15 [/SUP], Inger S Nijhof[SUP] 10 [/SUP]
Affiliations
Abstract
Vaccination guidelines for patients treated for hematological diseases are typically conservative. Given their high risk for severe coronavirus infectious disease 2019 (COVID-19) it is important to identify those patients that benefit from vaccination. We prospectively quantified serum IgG antibodies to spike subunit 1 (S1) antigens during and after 2-dose mRNA-1273 (Spikevax/Moderna) vaccination in hematology patients. Obtaining S1 IgG ≥300 binding antibody units (BAU)/ml was considered adequate as it represents the lower level of S1 IgG concentration obtained in healthy individuals and it correlates with potent virus neutralization. Selected patients (n=723) were severely immunocompromised due to their disease or treatment thereof. Nevertheless, more than 50% of patients obtained S1 IgG ≥300 BAU/ml after 2-dose mRNA-1273. All patients with sickle cell disease or chronic myeloid leukemia obtained adequate antibody concentrations. Around 70% of patients with chronic graft versus host disease (GvHD), multiple myeloma, or untreated chronic lymphocytic leukemia (CLL) obtained S1 IgG ≥300 BAU/ml. Ruxolitinib or hypomethylating therapy but not high-dose chemotherapy blunted responses in myeloid malignancies. Responses in lymphoma patients, CLL patients on ibrutinib, and chimeric antigen receptor T cell recipients were low. The minimal time-interval after autologous hematopoietic cell transplantation (HCT) to reach adequate concentrations was <2 months for multiple myeloma, 8 months for lymphoma, and 4-6 months after allogeneic HCT. Serum IgG4, absolute B and NK cell number and number of immunosuppressants predicted S1 IgG ≥300 BAU/ml. Hematology patients on chemotherapy, shortly after HCT, or with chronic GvHD should not be precluded from vaccination. Netherlands Trial Register NL9553.
. 2022 Feb 3;bloodadvances.2021006917.
doi: 10.1182/bloodadvances.2021006917. Online ahead of print.
Quantitative analysis of mRNA-1273 COVID-19 vaccination response in immunocompromised adult hematology patients
Sabine Haggenburg[SUP] 1 [/SUP], Birgit I Lissenberg-Witte[SUP] 2 [/SUP], Rob S Van BInnendijk[SUP] 3 [/SUP], Gerco Den Hartog[SUP] 3 [/SUP], Michel S Bhoekhan[SUP] 1 [/SUP], Nienke J E Haverkate[SUP] 1 [/SUP], Dennis Michel De Rooij[SUP] 1 [/SUP], Johan van Meerloo[SUP] 4 [/SUP], Jacqueline Cloos[SUP] 4 [/SUP], Neeltje A Kootstra[SUP] 1 [/SUP], Dorine Wouters[SUP] 1 [/SUP], Suzanne S Weijers[SUP] 1 [/SUP], Ester M M van Leeuwen[SUP] 1 [/SUP], Hetty J Bontkes[SUP] 5 [/SUP], Saida Tonouh-Aajoud[SUP] 1 [/SUP], Mirjam H M Heemskerk[SUP] 6 [/SUP], Rogier Sanders[SUP] 7 [/SUP], Elianne Roelandse-Koop[SUP] 1 [/SUP], Quincy Hofsink[SUP] 1 [/SUP], Kazimierz Groen[SUP] 1 [/SUP], Lusia A Çetinel[SUP] 1 [/SUP], Louis Schellekens[SUP] 1 [/SUP], Yvonne M den Hartog[SUP] 1 [/SUP], Belle Toussaint[SUP] 1 [/SUP], Iris M J Kant[SUP] 1 [/SUP], Thecla Margaretha Graas/Bouman[SUP] 1 [/SUP], Emma de Pater[SUP] 8 [/SUP], Willem Arnout Dik[SUP] 9 [/SUP], Marije D Engel[SUP] 1 [/SUP], Cheyenne R N Pierie[SUP] 1 [/SUP], Susanne R Janssen[SUP] 1 [/SUP], Meliawati Poniman[SUP] 1 [/SUP], Judith A Burger[SUP] 1 [/SUP], Joey H Bouhuijs[SUP] 1 [/SUP], Gaby Smits[SUP] 3 [/SUP], Nynke Y Rots[SUP] 3 [/SUP], Sonja Zweegman[SUP] 10 [/SUP], A P Kater[SUP] 11 [/SUP], Tom van Meerten[SUP] 12 [/SUP], Pim G N J Mutsaers[SUP] 13 [/SUP], Jaap van Doesum[SUP] 14 [/SUP], Annoek E C Broers[SUP] 9 [/SUP], Marit van Gils[SUP] 1 [/SUP], Abraham Goorhuis[SUP] 1 [/SUP], Caroline Rutten[SUP] 1 [/SUP], Mette D Hazenberg[SUP] 15 [/SUP], Inger S Nijhof[SUP] 10 [/SUP]
Affiliations
- PMID: 35114690
- DOI: 10.1182/bloodadvances.2021006917
Abstract
Vaccination guidelines for patients treated for hematological diseases are typically conservative. Given their high risk for severe coronavirus infectious disease 2019 (COVID-19) it is important to identify those patients that benefit from vaccination. We prospectively quantified serum IgG antibodies to spike subunit 1 (S1) antigens during and after 2-dose mRNA-1273 (Spikevax/Moderna) vaccination in hematology patients. Obtaining S1 IgG ≥300 binding antibody units (BAU)/ml was considered adequate as it represents the lower level of S1 IgG concentration obtained in healthy individuals and it correlates with potent virus neutralization. Selected patients (n=723) were severely immunocompromised due to their disease or treatment thereof. Nevertheless, more than 50% of patients obtained S1 IgG ≥300 BAU/ml after 2-dose mRNA-1273. All patients with sickle cell disease or chronic myeloid leukemia obtained adequate antibody concentrations. Around 70% of patients with chronic graft versus host disease (GvHD), multiple myeloma, or untreated chronic lymphocytic leukemia (CLL) obtained S1 IgG ≥300 BAU/ml. Ruxolitinib or hypomethylating therapy but not high-dose chemotherapy blunted responses in myeloid malignancies. Responses in lymphoma patients, CLL patients on ibrutinib, and chimeric antigen receptor T cell recipients were low. The minimal time-interval after autologous hematopoietic cell transplantation (HCT) to reach adequate concentrations was <2 months for multiple myeloma, 8 months for lymphoma, and 4-6 months after allogeneic HCT. Serum IgG4, absolute B and NK cell number and number of immunosuppressants predicted S1 IgG ≥300 BAU/ml. Hematology patients on chemotherapy, shortly after HCT, or with chronic GvHD should not be precluded from vaccination. Netherlands Trial Register NL9553.