Humoral and cellular immune responses after three or four doses of BNT162b2 in patients with hematological malignancies.

Abstract

OBJECTIVES:

Initial responses to coronavirus disease 2019 vaccination are impaired in patients with hematological malignancies. We investigated immune responses after three or four doses of BNT162b2 in patients with myeloid and lymphoid malignancies compared to controls, and identified risk factors for humoral and cellular nonresponse 1 year after first vaccination.

METHODS:

In 407 hematological patients (45 myeloid, 362 lymphoid) and 98 matched controls, we measured immunoglobulin G (IgG) and neutralizing antibodies specific for the receptor-binding domain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at baseline, 3 weeks, 2, 6, and 12 months, and interferon-γ release at 12 months.

RESULTS:

In patients with lymphoid malignancies, SARS-CoV-2 receptor-binding domain IgG concentration and mean neutralizing capacity was lower than in controls at all time points. A diagnosis of chronic lymphocytic B-cell leukemia (CLL) or lymphoma was associated with humoral nonresponse at 12 months compared to having multiple myeloma/amyloidosis (p < .001 and p = .013). Compared to controls, patients with lymphoid malignancies had increased risk of cellular nonresponse. A lymphoma diagnosis was associated with lower risk of cellular nonresponse compared to patients with multiple myeloma/amyloidosis, while patients with CLL had comparable response rates to patients with multiple myeloma/amyloidosis (p = .037 and p = .280).

CONCLUSIONS:

In conclusion, long-term humoral and cellular immune responses to BNT162b2 were impaired in patients with lymphoid malignancies.

• Authors: Line Dam Heftdal, Sebastian Rask Hamm, Laura Pérez-Alós, Johannes Roth Madsen, Jose Juan Almagro Armenteros, Kamille Fogh, Christoffer Cronwald Kronborg, Anders Pommer Vallentin, Rasmus Bo Hasselbalch, Dina Leth Møller, Cecilie Bo Hansen, Mia Pries-Heje, Anne Ortved Gang, Sisse Rye Ostrowski, Ruth Frikke-Schmidt, Erik Sørensen, Linda Hilsted, Henning Bundgaard, Kasper Iversen, Peter Garred, Susanne Dam Nielsen, Kirsten Grønbaek
• Journal: European journal of haematology (Eur J Haematol) Vol. 111 Issue 2 Pg. 229-239 (Aug 2023) ISSN: 1600-0609 [Electronic] England
• PMID: 37151174 (Publication Type: Journal Article)
• Copyright: © 2023 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.

Chemical References

• BNT162 Vaccine
• Immunoglobulin G
• Antibodies, Viral

Topics

• Humans
• Multiple Myeloma
• BNT162 Vaccine
• Leukemia, Lymphocytic, Chronic, B-Cell
• COVID-19
• SARS-CoV-2
• Hematologic Neoplasms (diagnosis)
• Amyloidosis
• Immunoglobulin G
• Immunity, Cellular
• Antibodies, Viral
• Vaccination