Serological and cellular response to mRNA-SARS-CoV2 vaccine in patients with hematological lymphoid malignancies: Results of the study "Cervax".

Autor:	Mohamed S; UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy., Lucchini E; UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy., Sirianni F; SC Laboratorio Analisi, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy., Porrazzo M; UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy., Ballotta L; UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy.; Dipartimento di Scienze Mediche, Chirurgiche e della Salute, University of Trieste, Trieste, Italy., Ballerini M; UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy., De Sabbata GM; UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy., De Bellis E; UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy., Cappuccio I; UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy., Granzotto M; SC Laboratorio Analisi, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy., Toffoletto B; SC Laboratorio Analisi, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy., Fortunati I; Dipartimento di Scienze Mediche, Chirurgiche e della Salute, University of Trieste, Trieste, Italy., Russignan A; Dipartimento di Medicina, sezione Ematologia, University of Verona, Verona, Italy., Florea EE; Dipartimento di Medicina, sezione Ematologia, University of Verona, Verona, Italy., Torelli L; Dipartimento di Scienze Mediche, Chirurgiche e della Salute, University of Trieste, Trieste, Italy., Zaja F; UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy.; Dipartimento di Scienze Mediche, Chirurgiche e della Salute, University of Trieste, Trieste, Italy.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2023 Feb 27; Vol. 13, pp. 1133348. Date of Electronic Publication: 2023 Feb 27 (Print Publication: 2023).
DOI:	10.3389/fonc.2023.1133348
Abstrakt:	messenger RNA (mRNA)-Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) vaccines such as BNT162b2 became available in late 2020, but hematological malignancy patients (HM pts) were not evaluated in initial registration trials. We hereby report the results of a prospective, unicentric, observational study Response to COVID-19 Vaccination in hEmatological malignancies (CERVAX) developed to assess the postvaccine serological and T-cell-mediated response in a cohort of SARS-CoV2-negative HM pts vaccinated with BNT162b2. Patients with lymphomas [non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL)], chronic lymphocytic leukemia (CLL), and multiple myeloma (MM); off-therapy for at least 3 months; in a watch-and-wait program; or in treatment with ibrutinib, venetoclax, and lenalidomide were included. Different time points were considered to assess the serological response to the vaccine: before the second dose (T1), at 3-6-12 months after the first dose (T2-3-4, respectively). Since March 2021, 39 pts have been enrolled: 15 (38%) NHL, 12 (31%) CLL, and 12 (31%) MM. There were 13 of the 39 pts (33%) seroconverted at T1; an increase of the serological response was registered after the second dose (T2) (22/39 pts, 56%) and maintained after 6 months (22/39 pts, 56%) and 12 months (24/39 pts, 61%) from the first dose (T3-T4, respectively). Non-serological responders at T4 were 7/39 (18%): 0/15 NHL, 1/12 MM (8%), and 6/12 CLL (50%). All of them were on therapy (one lenalidomide, three ibrutinib, and three venetoclax). SARS-CoV2-reactive T-cell analysis (interferon gamma release assays) was available since June 2022 and was evaluated at 12 months (T4) from the first dose of vaccine in 31/39 pts (79%). T-cell-mediated-responders were 17/31 (55%): most of them were NHL and MM (47%, 41% and 12% for NHL, MM, and CLL, respectively). Both serological and T-cell non-responders were represented by pts on active therapy (venetoclax/ibrutinib). During the period of observation, eight (20.5%) pts developed mild SARS-CoV2 infection; no coronavirus disease 19 (COVID-19)-related deaths or hospitalizations were registered. In conclusion, in our cohort of lymphoproliferative pts receiving BNT162b2, CLL diagnosis and venetoclax/ibrutinib seem to be related with a lower humoral or T-mediated response. Nevertheless, the efficacy of mRNA vaccine in HM pts and the importance to continue the vaccine program even in non-responders after the first dose are supported in our study by demonstrating that a humoral and T-cell-mediated seroconversion should be observed even in the subsets of heavily immunocompromised pts. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Mohamed, Lucchini, Sirianni, Porrazzo, Ballotta, Ballerini, De Sabbata, De Bellis, Cappuccio, Granzotto, Toffoletto, Fortunati, Russignan, Florea, Torelli and Zaja.)
Databáze:	MEDLINE
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