Greater preservation of SARS-CoV-2 neutralising antibody responses following the ChAdOx1-S (AZD1222) vaccine compared with mRNA vaccines in haematopoietic cell transplant recipients.

Autor: Colton H; Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.; NIHR Sheffield Biomedical Research Centre and the Florey Institute of Infection, University of Sheffield, Sheffield, UK., Barratt N; Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.; NIHR Sheffield Biomedical Research Centre and the Florey Institute of Infection, University of Sheffield, Sheffield, UK., Temperton N; Viral Pseudotype Unit, Medway School of Pharmacy, Universities of Kent and Greenwich, Chatham, UK., Hornsby H; Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.; NIHR Sheffield Biomedical Research Centre and the Florey Institute of Infection, University of Sheffield, Sheffield, UK., Angyal A; Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.; NIHR Sheffield Biomedical Research Centre and the Florey Institute of Infection, University of Sheffield, Sheffield, UK., Grouneva I; Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.; NIHR Sheffield Biomedical Research Centre and the Florey Institute of Infection, University of Sheffield, Sheffield, UK., Lindsey BB; Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.; NIHR Sheffield Biomedical Research Centre and the Florey Institute of Infection, University of Sheffield, Sheffield, UK., Kearns P; Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, UK., Barnes E; Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK., Goodyear CS; College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK., Richter A; Clinical Immunology Service, University of Birmingham, Birmingham, UK., Thomas D; The Cambridge Institute for Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, UK., Cook G; National Institute for Health Research, Leeds MIC, University of Leeds, Leeds, UK., McInnes IB; College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK., Willicombe M; Department of Immunology and Inflammation, Centre for Inflammatory Disease, Imperial College London, London, UK., Siebert S; College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK., Orchard K; Department of Haematology, University Hospital Southampton NHS Foundation Trust, Southampton, UK., Selby R; Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK., Bowden S; Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, UK., Collini PJ; Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.; NIHR Sheffield Biomedical Research Centre and the Florey Institute of Infection, University of Sheffield, Sheffield, UK., Pope A; Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, UK., Kirkham A; Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, UK., Kronsteiner B; Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK., Dunachie SJ; Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK., Miller P; British Society of Blood and Marrow Transplantation and Cellular Therapy, Guy's Hospital, London, UK., Clay J; Department of Haematology, St James's University Hospital, Leeds, UK., Hurst E; Northern Centre for Cancer Care, Freeman Hospital, Newcastle, UK., Malladi R; Department of Haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Kesavan M; Department of Oncology, Cancer and Haematology Centre, Churchill Hospital, Oxford, UK., Kinsella F; Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Sanderson R; King's College Hospital NHS Foundation Trust, London, UK., Yong KL; Department of Haematology, Cancer Institute, University College London, London, UK., Rea D; Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, UK., Parry H; Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Lim SH; Centre for Cancer Immunology, University of Southampton, Southampton, UK., Snowden JA; Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.; NIHR Sheffield Biomedical Research Centre and the Florey Institute of Infection, University of Sheffield, Sheffield, UK.; Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK., de Silva TI; Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.; NIHR Sheffield Biomedical Research Centre and the Florey Institute of Infection, University of Sheffield, Sheffield, UK.; Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2024 Dec; Vol. 205 (6), pp. 2206-2218. Date of Electronic Publication: 2024 Nov 17.
DOI: 10.1111/bjh.19874
Abstrakt: Whilst SARS-CoV-2 mRNA vaccines generate high neutralising antibodies (nAb) in most individuals, haematopoietic stem cell transplant (HSCT) and chimeric antigen receptor T-cell (CAR-T) recipients respond poorly. HSCT/CAR-T treatment ablates existing immune memory, with recipients requiring revaccination analogous to being vaccine naive. An optimal revaccination strategy for this cohort has not been defined. Factors predicting immunogenicity following three ancestral SARS-CoV-2 vaccines were assessed in 198 HSCT/CAR-T recipients and 96 healthcare workers (HCWs) recruited to multicentre studies. Only 25% of HSCT/CAR-T recipients generated nAbs following one dose, with titres 167-fold and 7-fold lower than that in HCWs after the first and second doses, respectively. Lower post-second dose nAb titres were associated with older age, rituximab use, and previous HSCT. ChAdOx1-S recipients were more likely to generate nAbs compared with mRNA vaccines, with titres comparable to HCWs. In contrast, nAbs were significantly lower in HSCT/CAR-T recipients than HCWs after mRNA vaccination. The poor first-dose immunogenicity in HSCT/CAR-T recipients suggests a minimum licensed dosing interval could limit the period of vulnerability following HSCT/CAR-T. The relative preservation of nAbs with ChAdOx1-S vaccination highlights the importance of evaluating alternative platforms to mRNA vaccination within this highly vulnerable clinical cohort.
(© 2024 The Author(s). British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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