Definition of factors associated with negative antibody response after COVID-19 vaccination in patients with hematological diseases

Medientyp: E-Artikel

Titel: Definition of factors associated with negative antibody response after COVID-19 vaccination in patients with hematological diseases

Beteiligte: Rotterdam, Jil [Verfasser:in]; Thiaucourt, Margot [Verfasser:in]; Weiß, Christel [Verfasser:in]; Schwaab, Juliana [Verfasser:in]; Reiter, Andreas [Verfasser:in]; Kreil, Sebastian [Verfasser:in]; Steiner, Laurenz [Verfasser:in]; Fenchel, Sebastian [Verfasser:in]; Popp, Henning [Verfasser:in]; Hofmann, Wolf-Karsten [Verfasser:in]; Bonatz, Karin [Verfasser:in]; Gerhards, Catharina [Verfasser:in]; Neumaier, Michael [Verfasser:in]; Klein, Stefan [Verfasser:in]; Rao, Sonika [Verfasser:in]; Jawhar, Mohamad [Verfasser:in]; Saußele, Susanne [Verfasser:in]

Erschienen: 21 May 2022

Sprache: Englisch

DOI: 10.1007/s00277-022-04866-z

Identifikator:

Schlagwörter: COVID-19 vaccination ; Hematological diseases/disorders ; SARS-CoV-2 ; Seroconversion

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Beschreibung: COVID-19 in patients with hematological diseases is associated with a high mortality. Moreover, preventive vaccination demonstrated reduced efficacy and the knowledge on influencing factors is limited. In this single-center study, antibody levels of the SARS-CoV-2 spike protein were measured ≥ 2 weeks after 2nd COVID-19 vaccination with a concentration ≥ 0.8 U/mL considered positive. Between July and October 2021, in a total of 373 patients (median age 64 years, 44% women) with myeloid neoplasms (n = 214, 57%), lymphoid neoplasms (n = 124, n = 33%), and other diseases (n = 35, 10%), vaccination was performed with BNT162b2 (BioNTech), mRNA-1273 (Moderna), ChADOx1 (AstraZeneca), or a combination. A total of 229 patients (61%) were on active therapy within 3 months prior vaccination and 144 patients (39%) were previously treated or treatment naïve. Vaccination-related antibody response was negative in 56/373 patients (15%): in 39/124 patients with lymphoid neoplasms, 13/214 with myeloid neoplasms, and 4/35 with other diseases. Active treatment per se was not correlated with negative response. However, rituximab and BTK inhibitor treatment were correlated significantly with a negative vaccination response, whereas younger age and chronic myeloid leukemia (CML) disease were associated with positive response. In addition, 5 of 6 patients with myeloproliferative neoplasm (MPN) and negative vaccination response were on active treatment with ruxolitinib. In conclusion, a remarkable percentage of patients with hematological diseases had no response after 2nd COVID-19 vaccination. Multivariable analysis revealed important factors associated with response to vaccination. The results may serve as a guide for better protection and surveillance in this vulnerable patient cohort.

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