Abstract
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.
Keywords: COVID-19 vaccination; Hematological diseases/disorders; SARS-CoV-2; Seroconversion.
【저자키워드】 SARS-CoV-2, Seroconversion, COVID-19 vaccination, Hematological diseases/disorders, 【초록키워드】 COVID-19, Treatment, Efficacy, vaccination, therapy, antibody, mRNA-1273, knowledge, Antibody Response, Spike protein, BNT162b2, Surveillance, Patient, age, ruxolitinib, women, disease, leukemia, AstraZeneca, Moderna, Combination, neoplasm, Concentration, Analysis, Neoplasms, active treatment, Factor, other diseases, median age, high mortality, naïve, BTK inhibitor, hematological, positive response, single-center study, positive, lymphoid, patient cohort, CML, significantly, addition, was performed, reduced, treated, demonstrated, correlated, had no, were measured, not correlated, other disease, response to vaccination, the SARS-CoV-2, 【제목키워드】 Patient, disease, Definition, Factor, hematological, negative antibody response,