Weak immunogenicity of SARS-CoV-2 vaccine in patients with hematologic malignancies (Équipe Mohty)

12 - Août - 2021

Florent Malard, Béatrice Gaugler, Joël Gozlan, Lucie Bouquet, Djeneba Fofana, Lama Siblany, Deborah Eshagh, Olivier Adotevi, Caroline Laheurte, Laure Ricard, Rémy Dulery, Nicolas Stocker, Zoé van de Wyngaert, Alexis Genthon, Anne Banet, Mara Memoli, Souhila Ikhlef, Simona Sestilli, Anne Vekhof, Eolia Brissot, Zora Marjanovic, Yannick Chantran, Nancy Cuervo, Éric Ballot, Laurence Morand-Joubert, Mohamad Mohty

Blood Cancer J 11 (2021): 142

This study evaluated the safety and immunogenicity of BNT162b2 vaccine in patients with hematological malignancies. Antibodies blocking spike binding to immobilized ACE-2 (NAb) correlated with anti-Spike (S) IgG d42 titers (Spearman r = 0.865, p < 0.0001), and an anti-S IgG d42 level >/=3100 UA/mL was predictive of NAb >/= 30%, the positivity cutoff for NAb (p < 0.0001). Only 47% of the patients achieved an anti-S IgG d42 level >/=3100 UA/mL after the two BNT162b2 inocula, compared to 87% of healthy controls. In multivariable analysis, male patients, use of B-cell targeting treatment within the last 12 months prior to vaccination, and CD19(+) B-cell level <120/uL, were associated with a significantly decreased probability of achieving a protective anti-S IgG level after the second BNT162b2 inoculum. Finally, using the IFN-gamma ELISPOT assay, we found a significant increase in T-cell response against the S protein, with 53% of patients having an anti-S IgG-positive ELISPOT after the second BNT162b2 inoculum. There was a correlation between the anti-S ELISPOT response and IgG d42 level (Spearman r = 0.3026, p = 0.012). These findings suggest that vaccination with two BNT162b2 inocula translates into a significant increase in humoral and cellular response in patients with hematological malignancies, but only around half of the patients can likely achieve effective immune protection against COVID-19.

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