Cellular and humoral immunogenicity of the mRNA-1273 SARS-CoV-2 vaccine in patients with hematologic malignancies

被引：45

作者：

Jimenez, Moraima ^{[1
,2
]}

Roldan, Elisa ^{[1
,2
]}

Fernandez-Naval, Candela ^{[3
]}

Villacampa, Guillermo ^{[4
]}

Martinez-Gallo, Monica ^{[5
,6
]}

Medina-Gil, Daniel ^{[2
,7
]}

Peralta-Garzon, Soraya ^{[2
,7
]}

Pujadas, Gemma ^{[2
,7
]}

Hernandez, Cristina ^{[2
,7
]}

Pages, Carlota ^{[2
,7
]}

Gironella, Mercedes ^{[1
,2
]}

Fox, Laura ^{[1
,2
]}

Orti, Guillermo ^{[1
,2
]}

Barba, Pere ^{[1
,2
]}

Pumarola, Tomas ^{[3
]}

Cabirta, Alba ^{[1
]}

Catala, Eva ^{[1
]}

Valentin, Mercedes ^{[1
]}

Marin-Niebla, Ana ^{[1
]}

Orfao, Alberto ^{[8
]}

Gonzalez, Marcos ^{[9
,10
]}

Campins, Magda ^{[11
]}

Ruiz-Camps, Isabel ^{[12
]}

Valcarcel, David ^{[1
,2
]}

Bosch, Francesc ^{[1
,2
]}

Hernandez, Manuel ^{[5
,6
]}

Crespo, Marta ^{[2
,7
]}

Esperalba, Juliana ^{[3
]}

Abrisqueta, Pau ^{[1
,2
]}

机构：

[1] Vall dHebron Hosp Univ, Vall dHebron Inst Oncol VHIO, Serv Hematol, Expt Hematol, Vall dHebron Barcelona Hosp Campus, Barcelona 08035, Spain

[2] Univ Autonoma Barcelona, Dept Med, Bellaterra, Spain

[3] Vall dHebron Hosp Univ, Vall dHebron Inst Recerca VHIR, Dept Microbiol, Vall dHebron Barcelona Hosp Campus, Barcelona, Spain

[4] Vall dHebron Inst Oncol VHIO, Oncol Data Sci ODysSey Grp, Barcelona, Spain

[5] Vall dHebron Hosp Univ, Vall dHebron Res Inst, Dept Immunol, Vall dHebron Barcelona Hosp Campus, Barcelona, Spain

[6] Autonomous Univ Barcelona UA, Dept Cell Biol Physiol & Immunol, Barcelona, Spain

[7] Vall dHebron Inst Oncol VHIO, Expt Hematol, Vall dHebron Barcelona Hosp Campus, Barcelona, Spain

[8] Canc Res Ctr IBMCC CSIC USAL IBSAL, Dept Med & Cytometry Gen Serv Nucleus, Salamanca, Spain

[9] Univ Hosp Salamanca HUS IBSAL, Dept Hematol, CIBERONC CB16 12 00233, Salamanca, Spain

[10] Ctr Canc Res IBMCC USAL CSIC, Salamanca, Spain

[11] Vall dHebron Hosp Univ, Vall dHebron Res Inst, Dept Prevent Med & Epidemiol, Vail dHebron Barcelona Hosp Campus, Barcelona, Spain

[12] Vall dHebron Hosp Univ, Vall dHebron Res Inst, Dept Infect Dis, Vall dHebron Barcelona Hosp Campus, Barcelona, Spain

来源：

BLOOD ADVANCES | 2022年 / 6卷 / 03期

关键词：

ANTIBODY; SAFETY; RESPONSES; THERAPY;

D O I：

10.1182/bloodadvances.2021006101

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Recent studies have shown a suboptimal humoral response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in patients diagnosed with hematologic malignancies; however, data about cellular immunogenicity are scarce. The aim of this study was to evaluate both the humoral and cellular immunogenicity 1 month after the second dose of the mRNA-1273 vaccine. Antibody titers were measured by using the Elecsys and LIAISON anti-SARS-CoV-2 S assays, and T-cell response was assessed by using interferon-g release immunoassay technology. Overall, 76.3% (184 of 241) of patients developed humoral immunity, and the cellular response rate was 79% (184 of 233). Hypogammaglobulinemia, lymphopenia, active hematologic treatment, and anti-CD20 therapy during the previous 6 months were associated with an inferior humoral response. Conversely, age .65 years, active disease, lymphopenia, and immunosuppressive treatment of graft-versus-host disease (GVHD) were associated with an impaired cellular response. A significant dissociation between the humoral and cellular responses was observed in patients treated with anti-CD20 therapy (the humoral response was 17.5%, whereas the cellular response was 71.1%). In these patients, B-cell aplasia was confirmed while T-cell counts were preserved. In contrast, humoral response was observed in 77.3% of patients undergoing immunosuppressive treatment of GVHD, whereas only 52.4% had a cellular response. The cellular and humoral responses to the SARS-CoV-2 mRNA-1273 vaccine in patients with hematologic malignancies are highly influenced by the presence of treatments such as anti-CD20 therapy and immunosuppressive agents. This observation has implications for the further management of these patients.

引用

页码：774 / 784

页数：11

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