Immunocompromised patients are considered high-risk and prioritized for vaccination against COVID-19. We aimed to analyze B-cell subsets in these patients to identify potential predictors of humoral vaccination response. Patients (n=120) suffering from hematologic malignancies or other causes of immunodeficiency and healthy controls (n=79) received a full vaccination series with an mRNA vaccine. B-cell subsets were analyzed prior to vaccination. Two independent anti-SARS-CoV-2 immunoassays targeting the receptor-binding domain (RBD) or trimeric S protein (TSP) were performed three to four weeks after the second vaccination. Seroconversion occurred in 100% of healthy controls, in contrast to 67% (RBD) and 82% (TSP) of immunocompromised patients, while only 32% (RBD) and 22% (TSP) achieved antibody levels comparable to those of healthy controls. The number of circulating CD19 + IgD + CD27 – naïve B cells was strongly associated with antibody levels (ρ=0.761, P<0.001) and the only independent predictor for achieving antibody levels comparable to healthy controls (OR 1.07 per 10-µL increase, 95%CI 1.02–1.12, P=0.009). Receiver operating characteristic analysis identified a cut-off at ≥61 naïve B cells per µl to discriminate between patients with and without an optimal antibody response. Consequently, measuring of naïve B cells in immunocompromised hematologic patients could be useful in predicting their humoral vaccination response.
【저자키워드】 COVID-19, mRNA vaccine, Cancer, B cells, immunodeficiencies, 【초록키워드】 vaccination, antibody, Antibody Response, immunodeficiency, Immunocompromised patients, anti-SARS-CoV-2, immunoassay, RBD, Patient, Immunocompromised, predictor, B-cell, CD27, Analysis, Hematologic malignancy, humoral, CD19, IGD, receiver operating characteristic, 95%CI, second vaccination, healthy control, healthy controls, circulating, cut-off, hematologic, trimeric S protein, vaccination against COVID-19, independent, analyzed, identify, performed, occurred, the receptor-binding domain, comparable, cause, subset, naïve B cell, 【제목키워드】 COVID 19, mRNA, response,