Antibody Response to the SARS-CoV-2 Vaccine and COVID-19 Vulnerability during the Omicron Pandemic in Patients with CLL: Two-Year Follow-Up of a Multicenter Study.

Autor: Mauro FR; Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy., Giannarelli D; Design and Analysis of Clinical Trials Unit, Scientific Directorate, IRCS Fondazione Policlinico Universitario A. Gemelli, 00168 Rome, Italy., Galluzzo CM; National Center for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy., Visentin A; Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, 35122 Padova, Italy., Frustaci AM; ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., Sportoletti P; Institute of Hematology and Center for Hemato-Oncology Research, University of Perugia and Santa Maria della Misericordia Hospital, 06129 Perugia, Italy., Vitale C; Department of Molecular Biotechnology and Health Sciences, University of Torino and Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, 10125 Torino, Italy., Reda G; Hematology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy., Gentile M; Hematology Unit AO of Cosenza, Cosenza and Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy., Levato L; Department Hematology-Oncology, Azienda Ospedaliera Pugliese-Ciaccio, 88100 Catanzaro, Italy., Murru R; Hematology and Stem Cell Transplantation Unit, Ospedale Oncologico A. Businco, ARNAS 'G. Brotzu', 09134 Cagliari, Italy., Armiento D; Unit of Hematology, Stem Cell Transplantation, University Campus Bio-Medico, 00128 Rome, Italy., Molinari MC; Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy., Proietti G; Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy., Pepe S; Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy., De Falco F; Institute of Hematology and Center for Hemato-Oncology Research, University of Perugia and Santa Maria della Misericordia Hospital, 06129 Perugia, Italy., Mattiello V; Hematology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy., Barabino L; Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy., Amici R; National Center for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy., Coscia M; Department of Molecular Biotechnology and Health Sciences, University of Torino and Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, 10125 Torino, Italy., Tedeschi A; ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy., Girmenia C; Azienda Policlinico Umberto I, 00161 Roma, Italy., Trentin L; Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, 35122 Padova, Italy., Baroncelli S; National Center for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2023 May 30; Vol. 15 (11). Date of Electronic Publication: 2023 May 30.
DOI: 10.3390/cancers15112993
Abstrakt: High morbidity and mortality due to COVID-19 were described in the pre-vaccination era in patients with chronic lymphocytic leukemia (CLL). To evaluate COVID-19 morbidity after the SARS-CoV-2 vaccine, we carried out a prospective study in 200 CLL patients. The median age of patients was 70 years; 35% showed IgG levels ≤ 550 mg/dL, 61% unmutated IGHV, and 34% showed TP 53 disruption. Most patients, 83.5%, were previously treated, including 36% with ibrutinib and 37.5% with venetoclax. The serologic response rates to the second and third dose of the vaccine were 39% and 53%, respectively. With a median follow-up of 23.4 months, 41% of patients experienced COVID-19, 36.5% during the Omicron pandemic, and 10% had subsequent COVID-19 events. Severe COVID-19 requiring hospitalization was recorded in 26% of patients, and 4% died. Significant and independent factors associated with the response to the vaccine and vulnerability to COVID-19 were age (OR: 0.93; HR: 0.97) and less than 18 months between the start of targeted agents and vaccine (OR: 0.17; HR: 0.31). TP 53 mutation and ≥two prior treatments also emerged as significant and independent factors associated with an increased risk of developing COVID-19 (HR: 1.85; HR: 2.08). No statistical difference in COVID-19 morbidity was found in patients with or without antibody response to the vaccine (47.5% vs. 52.5%; p = 0.21). Given the persistent risk of infection due to the continuous emergence of SARS-CoV-2 variants, our results support the importance of new vaccines and protective measures to prevent and mitigate COVID-19 in CLL patients.
Databáze: MEDLINE
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