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

Autor:	Haggenburg S; Department of Hematology and., Lissenberg-Witte BI; Department of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam, The Netherlands., van Binnendijk RS; Centre for Immunology of Infectious Diseases and Vaccines, National Institute for Public Health and the Environment, Bilthoven, The Netherlands., den Hartog G; Centre for Immunology of Infectious Diseases and Vaccines, National Institute for Public Health and the Environment, Bilthoven, The Netherlands., Bhoekhan MS; Department of Hematology and., Haverkate NJE; Department of Experimental Immunology., de Rooij DM; Department of Experimental Immunology., van Meerloo J; Cancer Center Amsterdam., Cloos J; Cancer Center Amsterdam., Kootstra NA; Department of Experimental Immunology., Wouters D; Department of Clinical Chemistry., Weijers SS; Central Diagnostic Laboratory, and., van Leeuwen EMM; Department of Experimental Immunology.; Laboratory Medical Immunology, Amsterdam University Medical Center, Amsterdam, The Netherlands., Bontkes HJ; Laboratory Medical Immunology, Amsterdam University Medical Center, Amsterdam, The Netherlands., Tonouh-Aajoud S; Laboratory Medical Immunology, Amsterdam University Medical Center, Amsterdam, The Netherlands., Heemskerk MHM; Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands., Sanders RW; Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, Amsterdam, The Netherlands., Roelandse-Koop E; Department of Clinical Chemistry., Hofsink Q; Department of Hematology and., Groen K; Department of Hematology and., Çetinel L; Department of Hematology and., Schellekens L; Department of Hematology and., den Hartog YM; Department of Hematology and., Toussaint B; Department of Hematology and., Kant IMJ; Department of Hematology and., Graas T; Department of Hematology and., de Pater E; Department of Hematology and., Dik WA; Laboratory Medical Immunology, Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands., Engel MD; Department of Hematology and., Pierie CRN; Department of Hematology and., Janssen SR; Department of Hematology and., van Dijkman E; Department of Hematology and., Poniman M; Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, Amsterdam, The Netherlands., Burger JA; Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, Amsterdam, The Netherlands., Bouhuijs JH; Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, Amsterdam, The Netherlands., Smits G; Centre for Immunology of Infectious Diseases and Vaccines, National Institute for Public Health and the Environment, Bilthoven, The Netherlands., Rots NY; Centre for Immunology of Infectious Diseases and Vaccines, National Institute for Public Health and the Environment, Bilthoven, The Netherlands., Zweegman S; Department of Hematology and.; Cancer Center Amsterdam., Kater AP; Department of Hematology and.; Cancer Center Amsterdam., van Meerten T; Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands., Mutsaers PGNJ; Department of Hematology and., van Doesum JA; Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands., Broers AEC; Department of Hematology and., van Gils MJ; Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, Amsterdam, The Netherlands., Goorhuis A; Department of Infectious Diseases, Amsterdam University Medical Center, Amsterdam, The Netherlands; and., Rutten CE; Department of Hematology and., Hazenberg MD; Department of Hematology and.; Cancer Center Amsterdam.; Department of Hematopoiesis, Sanquin Research, Amsterdam, The Netherlands., Nijhof IS; Department of Hematology and.; Cancer Center Amsterdam.
Jazyk:	angličtina
Zdroj:	Blood advances [Blood Adv] 2022 Mar 08; Vol. 6 (5), pp. 1537-1546.
DOI:	10.1182/bloodadvances.2021006917
Abstrakt:	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. (© 2022 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)
Databáze:	MEDLINE
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