Analysis of immune responses in patients with CLL after heterologous COVID-19 vaccination.

Autor:	Lee HK; National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD., Hoechstetter MA; Munich Clinic Schwabing, Academic Teaching Hospital, Ludwig-Maximilian University, Munich, Germany., Buchner M; Institute of Clinical Chemistry and Pathobiochemistry, School of Medicine, Technical University of Munich, Munich, Germany.; TranslaTUM-Central Institute for Translational Cancer Research, Technische Universität München, Munich, Germany., Pham TT; Munich Clinic Schwabing, Academic Teaching Hospital, Ludwig-Maximilian University, Munich, Germany., Huh JW; Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Müller K; Bundeswehr Institute of Microbiology, Munich, Germany.; German Centre for Infection Research, Partner Site Munich, Munich, Germany., Zange S; Bundeswehr Institute of Microbiology, Munich, Germany.; German Centre for Infection Research, Partner Site Munich, Munich, Germany., von Buttlar H; Bundeswehr Institute of Microbiology, Munich, Germany.; German Centre for Infection Research, Partner Site Munich, Munich, Germany., Girl P; Bundeswehr Institute of Microbiology, Munich, Germany.; German Centre for Infection Research, Partner Site Munich, Munich, Germany., Wölfel R; Bundeswehr Institute of Microbiology, Munich, Germany.; German Centre for Infection Research, Partner Site Munich, Munich, Germany., Brandmeier L; Institute of Clinical Chemistry and Pathobiochemistry, School of Medicine, Technical University of Munich, Munich, Germany., Pfeuffer L; Institute of Clinical Chemistry and Pathobiochemistry, School of Medicine, Technical University of Munich, Munich, Germany., Furth PA; Departments of Oncology & Medicine, Georgetown University, Washington, DC., Wendtner CM; Munich Clinic Schwabing, Academic Teaching Hospital, Ludwig-Maximilian University, Munich, Germany., Hennighausen L; National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.
Jazyk:	angličtina
Zdroj:	Blood advances [Blood Adv] 2023 May 23; Vol. 7 (10), pp. 2214-2227.
DOI:	10.1182/bloodadvances.2022008445
Abstrakt:	Patients with chronic lymphocytic leukemia (CLL) treated with B-cell pathway inhibitors and anti-CD20 antibodies exhibit low humoral response rates following SARS-CoV-2 vaccination. To investigate this observation, a prospective single-institution study was conducted comparing peripheral blood mononuclear cell transcriptional response with antibody and T-cell response rates following heterologous BNT162b2/ChAdOx1 vaccination of 15 patients with CLL/small lymphocytic lymphoma (SLL). Two-dose antibody response rate was 40%, increasing to 53% after booster. Patients on Bruton tyrosine kinase inhibitor (BTKi) and venetoclax ± anti-CD20 antibody within 12 months of vaccination responded inferiorly compared with those under BTKi alone. The 2-dose-T-cell response rate was 80%, which increased to 93% after the booster dose. Key transcriptional findings were that interferon-mediated signaling activation including activation of the JAK-STAT pathway generally occurred within days of vaccination, but was independent from the magnitude of the antibody response. Increasing counts of IGHV genes were associated with B-cell reconstitution and improved humoral response rate in the vaccinated patients. T-cell responses in patients with CLL appeared independent of treatment status, whereas higher humoral response rate was associated with BTKi treatment and B-cell reconstitution. Boosting was particularly effective when intrinsic immune status was improved by CLL treatment. Limitations included studying a relatively small cohort, with different treatments and vaccination schedules. (Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution.)
Databáze:	MEDLINE
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