Abstract
Recent studies have shown a suboptimal humoral response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in patients diagnosed with hematologic malignancies; however, data about cellular immunogenicity are scarce. The aim of this study was to evaluate both the humoral and cellular immunogenicity 1 month after the second dose of the mRNA-1273 vaccine. Antibody titers were measured by using the Elecsys and LIAISON anti-SARS-CoV-2 S assays, and T-cell response was assessed by using interferon-γ release immunoassay technology. Overall, 76.3% (184 of 241) of patients developed humoral immunity, and the cellular response rate was 79% (184 of 233). Hypogammaglobulinemia, lymphopenia, active hematologic treatment, and anti-CD20 therapy during the previous 6 months were associated with an inferior humoral response. Conversely, age >65 years, active disease, lymphopenia, and immunosuppressive treatment of graft-versus-host disease (GVHD) were associated with an impaired cellular response. A significant dissociation between the humoral and cellular responses was observed in patients treated with anti-CD20 therapy (the humoral response was 17.5%, whereas the cellular response was 71.1%). In these patients, B-cell aplasia was confirmed while T-cell counts were preserved. In contrast, humoral response was observed in 77.3% of patients undergoing immunosuppressive treatment of GVHD, whereas only 52.4% had a cellular response. The cellular and humoral responses to the SARS-CoV-2 mRNA-1273 vaccine in patients with hematologic malignancies are highly influenced by the presence of treatments such as anti-CD20 therapy and immunosuppressive agents. This observation has implications for the further management of these patients.
【초록키워드】 Treatment, SARS-CoV-2, Vaccine, coronavirus, T-cell Response, anti-CD20 therapy, lymphopenia, immunoassay, Humoral immunity, Humoral response, mRNA, management, Patient, age, T-cell, disease, patients, Immunosuppressive agents, B-cell, GVHD, cellular response, Active disease, cellular, Hematologic malignancy, Immunosuppressive treatment, LIAISON, humoral, observation, Messenger RNA, interferon-γ, mRNA-1273 vaccine, acute respiratory syndrome, second dose, hematologic, Anti-SARS-CoV-2 S, implication, recent, shown, evaluate, assays, diagnosed, were measured, Elecsy, patients treated, preserved, the SARS-CoV-2, 【제목키워드】 mRNA-1273, SARS-CoV-2 vaccine, Patient, Hematologic malignancy, humoral immunogenicity,