Abstract
Objectives: To assess the humoral immune response to the BNT162b2 vaccine after allogeneic haematopoietic cell transplantation (HCT).
Methods: This is a prospective cohort study. The SARS-CoV-2 IgGII Quant (Abbott©) assay was performed 4-6 weeks after the second BNT162b2 vaccine for quantitative measurement of anti-spike antibodies.
Results: The cohort included 106 adult patients. Median time from HCT to vaccination was 42 (range 4-439) months. Overall, 15/106 (14%, 95% confidence interval (CI) 7-21%) were seronegative despite vaccination, 14/52 patients on immunosuppression (27%, 95%CI 19-35%) compared to only 1/54 patients off immunosuppression (1.8%, 95%CI 1-4%) (p 0.0002). The proportion of seronegative patients declined with time; it was 46% (6/13) during the first year, 12.5% (3/24) during the second year and 9% (6/69) beyond 2 years from transplant. Patients with acute graft-versus-host disease (GVHD) (odds ratio (OR) 3.3, 95%CI 0.97-11.1, p 0.06) and moderate to severe chronic GVHD (OR 5.9, 95%CI 1.2-29, p 0.03) were more likely to remain seronegative. Vaccination was well tolerated by most patients. However, 7% (7/106) reported that GVHD-related symptoms worsened within days following vaccination.
Conclusion: A significant proportion of allogeneic HCT recipients receiving immunosuppression demonstrated an inadequate humoral response to the BNT162b2 vaccine. These patients should be recognized and instructed to take appropriate precautions. Recipients who were off immunosuppression had a humoral response that was comparable to that of the general population.
Keywords: Allogeneic haematopoietic cell transplantation; BNT162b2 vaccine; Graft-versus-host disease; Immunosuppression; SARS-CoV-2.
【저자키워드】 SARS-CoV-2, BNT162b2 vaccine, Immunosuppression, Allogeneic haematopoietic cell transplantation, Graft-versus-host disease, 【초록키워드】 SARS-CoV-2, vaccination, Symptom, prospective cohort study, BNT162b2, Cohort, Patient, Allogeneic, humoral immune response, General population, disease, moderate, patients, seronegative, anti-spike antibodies, GVHD, Odds ratio, humoral, cell transplantation, 95%CI, 95% confidence interval, recipient, precautions, Cell, quantitative measurement, chronic GVHD, HCT, proportion, reported, receiving, was performed, demonstrated, comparable, declined, seronegative patient, worsened, 【제목키워드】 Allogeneic, serological response, cell transplantation,