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Quantitative analysis of mRNA-1273 COVID-19 vaccination response in immunocompromised adult hematology patients.


ABSTRACT: Vaccination guidelines for patients treated for hematological diseases are typically conservative. Given their high risk for severe COVID-19, it is important to identify those patients that benefit from vaccination. We prospectively quantified serum immunoglobulin G (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 (BAUs)/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 owing to their disease or treatment thereof. Nevertheless, >50% of patients obtained S1 IgG ≥ 300 BAUs/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 (cGVHD), multiple myeloma, or untreated chronic lymphocytic leukemia (CLL) obtained S1 IgG ≥ 300 BAUs/mL. Ruxolitinib or hypomethylating therapy but not high-dose chemotherapy blunted responses in myeloid malignancies. Responses in patients with lymphoma, patients with CLL 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 to 6 months after allogeneic HCT. Serum IgG4, absolute B- and natural killer-cell number, and number of immunosuppressants predicted S1 IgG ≥ 300 BAUs/mL. Hematology patients on chemotherapy, shortly after HCT, or with cGVHD should not be precluded from vaccination. This trial was registered at Netherlands Trial Register as #NL9553.

SUBMITTER: Haggenburg S 

PROVIDER: S-EPMC8816838 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Quantitative analysis of mRNA-1273 COVID-19 vaccination response in immunocompromised adult hematology patients.

Haggenburg Sabine S   Lissenberg-Witte Birgit I BI   van Binnendijk Rob S RS   den Hartog Gerco G   Bhoekhan Michel S MS   Haverkate Nienke J E NJE   de Rooij Dennis M DM   van Meerloo Johan J   Cloos Jacqueline J   Kootstra Neeltje A NA   Wouters Dorine D   Weijers Suzanne S SS   van Leeuwen Ester M M EMM   Bontkes Hetty J HJ   Tonouh-Aajoud Saïda S   Heemskerk Mirjam H M MHM   Sanders Rogier W RW   Roelandse-Koop Elianne E   Hofsink Quincy Q   Groen Kazimierz K   Çetinel Lucia L   Schellekens Louis L   den Hartog Yvonne M YM   Toussaint Belle B   Kant Iris M J IMJ   Graas Thecla T   de Pater Emma E   Dik Willem A WA   Engel Marije D MD   Pierie Cheyenne R N CRN   Janssen Suzanne R SR   van Dijkman Edith E   Poniman Meliawati M   Burger Judith A JA   Bouhuijs Joey H JH   Smits Gaby G   Rots Nynke Y NY   Zweegman Sonja S   Kater Arnon P AP   van Meerten Tom T   Mutsaers Pim G N J PGNJ   van Doesum Jaap A JA   Broers Annoek E C AEC   van Gils Marit J MJ   Goorhuis Abraham A   Rutten Caroline E CE   Hazenberg Mette D MD   Nijhof Inger S IS  

Blood advances 20220301 5


Vaccination guidelines for patients treated for hematological diseases are typically conservative. Given their high risk for severe COVID-19, it is important to identify those patients that benefit from vaccination. We prospectively quantified serum immunoglobulin G (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 (BAUs)/mL was considered adequate as it represen  ...[more]

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