1. Humoral and cellular immunogenicity of SARS-CoV-2 vaccines in chronic lymphocytic leukemia: a prospective cohort study
- Author
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J. Erika Haydu, Jenny S. Maron, Robert A. Redd, Kathleen M. E. Gallagher, Stephanie Fischinger, Jeffrey A. Barnes, Ephraim P. Hochberg, P. Connor Johnson, R. W. Takvorian, Katelin Katsis, Daneal Portman, Jade Ruiters, Sidney Sechio, Mary Devlin, Connor Regan, Kimberly G. Blumenthal, Aleena Banerji, Allen D. Judd, Krista J. Scorsune, Brianne M. McGree, Maryanne M. Sherburne, Julia M. Lynch, James I. Weitzman, Matthew Lei, Camille N. Kotton, Anand S. Dighe, Marcela V. Maus, Galit Alter, Jeremy S. Abramson, and Jacob D. Soumerai
- Subjects
Adult ,COVID-19 Vaccines ,Immunogenicity, Vaccine ,SARS-CoV-2 ,COVID-19 ,Humans ,Regular Article ,Hematology ,Prospective Studies ,Antibodies, Neutralizing ,Leukemia, Lymphocytic, Chronic, B-Cell - Abstract
Chronic lymphocytic leukemia (CLL), the most common leukemia worldwide, is associated with increased COVID-19 mortality. Previous studies suggest only a portion of vaccinated CLL patients develop severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike antibodies. Whether the elicited antibodies are functional and/or accompanied by functional T-cell responses is unknown. This prospective cohort study included patients with CLL who received SARS-CoV-2 and PCV13 vaccines (not concurrently). The primary cohort included adults with CLL off therapy. Coprimary outcomes were serologic response to SARS-CoV-2 (receptor binding domain [RBD] immunoassay) and PCV13 vaccines (23-serotype IgG assay). Characterization of SARS-CoV-2 antibodies and their functional activity and assessment of functional T-cell responses was performed. Sixty percent (18/30) of patients demonstrated serologic responses to SARS-CoV-2 vaccination, appearing more frequent among treatment-naïve patients (72%). Among treatment-naïve patients, an absolute lymphocyte count ≤24 000/µL was associated with serologic response (94% vs 14%; P < .001). On interferon-γ release assays, 80% (16/20) of patients had functional spike-specific T-cell responses, including 78% (7/9) with a negative RBD immunoassay, a group enriched for prior B-cell–depleting therapies. A bead-based multiplex immunoassay identified antibodies against wild-type and variant SARS-CoV-2 (α, β, γ, and δ) in all tested patients and confirmed Fc-receptor binding and effector functions of these antibodies. Of 11 patients with negative RBD immunoassay after vaccination, 6 (55%) responded to an additional mRNA-based vaccine dose. The PCV13 serologic response rate was 29% (8/28). Our data demonstrate that SARS-CoV-2 vaccination induces functional T-cell and antibody responses in patients with CLL and provides the framework for investigating the molecular mechanisms and clinical benefit of these responses. This trial was registered at www.clinicaltrials.gov as #NCT05007860.
- Published
- 2021