TY - JOUR
T1 - Quantitative analysis of mRNA-1273 COVID-19 vaccination response in immunocompromised adult hematology patients
AU - Haggenburg, Sabine
AU - Lissenberg-Witte, Birgit I.
AU - van Binnendijk, Rob S.
AU - den Hartog, Gerco
AU - Bhoekhan, Michel S.
AU - Haverkate, Nienke J.E.
AU - de Rooij, Dennis M.
AU - van Meerloo, Johan
AU - Cloos, Jacqueline
AU - Kootstra, Neeltje A.
AU - Wouters, Dorine
AU - Weijers, Suzanne S.
AU - van Leeuwen, Ester M.M.
AU - Bontkes, Hetty J.
AU - Tonouh-Aajoud, Saïda
AU - Heemskerk, Mirjam H.M.
AU - Sanders, Rogier W.
AU - Roelandse-Koop, Elianne
AU - Hofsink, Quincy
AU - Groen, Kazimierz
AU - Çetinel, Lucia
AU - Schellekens, Louis
AU - den Hartog, Yvonne M.
AU - Toussaint, Belle
AU - Kant, Iris M.J.
AU - Graas, Thecla
AU - de Pater, Emma
AU - Dik, Willem A.
AU - Engel, Marije D.
AU - Pierie, Cheyenne R.N.
AU - Janssen, Suzanne R.
AU - van Dijkman, Edith
AU - Poniman, Meliawati
AU - Burger, Judith A.
AU - Bouhuijs, Joey H.
AU - Smits, Gaby
AU - Rots, Nynke Y.
AU - Zweegman, Sonja
AU - Kater, Arnon P.
AU - van Meerten, Tom
AU - Mutsaers, Pim G.N.J.
AU - van Doesum, Jaap A.
AU - Broers, Annoek E.C.
AU - van Gils, Marit J.
AU - Goorhuis, Abraham
AU - Rutten, Caroline E.
AU - Hazenberg, Mette D.
AU - Nijhof, Inger S.
N1 - Funding Information:
Funding support for this article was provided by the Dutch Research Council (NWO / ZonMW) (10430072010009)
Funding Information:
This study was financially supported by the Dutch Research Council (NWO/ZonMW, grant 10430072010009) and Amsterdam UMC.
Publisher Copyright:
© 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.
PY - 2022/3/8
Y1 - 2022/3/8
N2 - 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 5 723) 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.
AB - 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 5 723) 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.
UR - http://www.scopus.com/inward/record.url?scp=85126092229&partnerID=8YFLogxK
U2 - 10.1182/bloodadvances.2021006917
DO - 10.1182/bloodadvances.2021006917
M3 - Article
C2 - 35114690
AN - SCOPUS:85126092229
SN - 2473-9529
VL - 6
SP - 1537
EP - 1546
JO - BLOOD ADVANCES
JF - BLOOD ADVANCES
IS - 5
ER -