tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2023 Jul 10;10(7)
fad349.
doi: 10.1093/ofid/ofad349. eCollection 2023 Jul. SARS-CoV-2 Vaccine-Induced Immune Responses Among Hematopoietic Stem Cell Transplant Recipients
Afoke Kokogho[SUP] 1 2 [/SUP], Trevor A Crowell[SUP] 3 4 [/SUP], Muneerah Aleissa[SUP] 1 5 2 [/SUP], Ana-Mihaela Lupan[SUP] 6 [/SUP], Sonya Davey[SUP] 1 5 [/SUP], Jun Bai Park Chang[SUP] 1 5 [/SUP], Lindsey R Baden[SUP] 1 5 2 [/SUP], Stephen R Walsh[SUP] 1 5 2 [/SUP], Amy C Sherman[SUP] 1 5 2 [/SUP]
Affiliations
Background: Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination reduces the risk and severity of coronavirus disease 2019 (COVID-19), several variables may impact the humoral response among patients undergoing hematopoietic stem cell transplantation (HSCT).
Methods: A retrospective chart review was conducted among SARS-CoV-2-vaccinated HSCT recipients between 2020 and 2022 at a single center in Boston, Massachusetts. Patients age ≥18 years who received doses of Pfizer, Moderna, or J&J vaccines were included. Anti-spike (S) immunoglobulin G (IgG) titer levels were measured using the Roche assay. Responders (≥0.8 U/mL) and nonresponders (<0.8 U/mL) were categorized and analyzed. Multivariable linear and logistic regression were used to estimate the correlation coefficient and odds ratio of response magnitude and status.
Results: Of 152 HSCT recipients, 141 (92.8%) were responders, with a median (interquartile range [IQR]) anti-S IgG titer of 2500 (107.9-2500) U/mL at a median (IQR) of 80.5 (36-153.5) days from last dose, regardless of the number of doses received. Higher quantitative titers were associated with receipt of more vaccine doses (coeff, 205.79; 95% CI, 30.10 to 381.47; P = .022), being female (coeff, 343.5; 95% CI, -682.6 to -4.4; P = .047), being younger (<65 years; coeff, 365.2; 95% CI, -711.3 to 19.1; P = .039), and not being on anti-CD20 therapy (coeff, -1163.7; 95% CI, -1717.7 to -609.7; P = .001). Being male (odds ratio [OR], 0.11; 95% CI, 0.01 to 0.93; P = .04) and being on anti-CD20 therapy (OR, 0.16; 95% CI, 0.03 to 0.70; P = .016) were associated with nonresponse.
Conclusions: Overall, most HSCT recipients had high SARS-CoV-2 antibody responses. More vaccine doses improved the magnitude of immune responses. Anti-S IgG monitoring may be useful for identifying attenuated vaccine-induced responses.
Keywords: COVID-19 vaccine; allogeneic HSCT; antispike protein; autologous HSCT transplant.
. 2023 Jul 10;10(7)
fad349.doi: 10.1093/ofid/ofad349. eCollection 2023 Jul. SARS-CoV-2 Vaccine-Induced Immune Responses Among Hematopoietic Stem Cell Transplant Recipients
Afoke Kokogho[SUP] 1 2 [/SUP], Trevor A Crowell[SUP] 3 4 [/SUP], Muneerah Aleissa[SUP] 1 5 2 [/SUP], Ana-Mihaela Lupan[SUP] 6 [/SUP], Sonya Davey[SUP] 1 5 [/SUP], Jun Bai Park Chang[SUP] 1 5 [/SUP], Lindsey R Baden[SUP] 1 5 2 [/SUP], Stephen R Walsh[SUP] 1 5 2 [/SUP], Amy C Sherman[SUP] 1 5 2 [/SUP]
Affiliations
- PMID: 37520415
- PMCID: PMC10372870
- DOI: 10.1093/ofid/ofad349
Background: Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination reduces the risk and severity of coronavirus disease 2019 (COVID-19), several variables may impact the humoral response among patients undergoing hematopoietic stem cell transplantation (HSCT).
Methods: A retrospective chart review was conducted among SARS-CoV-2-vaccinated HSCT recipients between 2020 and 2022 at a single center in Boston, Massachusetts. Patients age ≥18 years who received doses of Pfizer, Moderna, or J&J vaccines were included. Anti-spike (S) immunoglobulin G (IgG) titer levels were measured using the Roche assay. Responders (≥0.8 U/mL) and nonresponders (<0.8 U/mL) were categorized and analyzed. Multivariable linear and logistic regression were used to estimate the correlation coefficient and odds ratio of response magnitude and status.
Results: Of 152 HSCT recipients, 141 (92.8%) were responders, with a median (interquartile range [IQR]) anti-S IgG titer of 2500 (107.9-2500) U/mL at a median (IQR) of 80.5 (36-153.5) days from last dose, regardless of the number of doses received. Higher quantitative titers were associated with receipt of more vaccine doses (coeff, 205.79; 95% CI, 30.10 to 381.47; P = .022), being female (coeff, 343.5; 95% CI, -682.6 to -4.4; P = .047), being younger (<65 years; coeff, 365.2; 95% CI, -711.3 to 19.1; P = .039), and not being on anti-CD20 therapy (coeff, -1163.7; 95% CI, -1717.7 to -609.7; P = .001). Being male (odds ratio [OR], 0.11; 95% CI, 0.01 to 0.93; P = .04) and being on anti-CD20 therapy (OR, 0.16; 95% CI, 0.03 to 0.70; P = .016) were associated with nonresponse.
Conclusions: Overall, most HSCT recipients had high SARS-CoV-2 antibody responses. More vaccine doses improved the magnitude of immune responses. Anti-S IgG monitoring may be useful for identifying attenuated vaccine-induced responses.
Keywords: COVID-19 vaccine; allogeneic HSCT; antispike protein; autologous HSCT transplant.