Abstract
Patients affected by lymphoid malignancies (LM) are frequently immune-compromised, suffering increased mortality from COVID-19. This prospective study evaluated serological and T-cell responses after complete mRNA vaccination in 263 patients affected by chronic lymphocytic leukaemia, B- and T-cell lymphomas and multiple myeloma. Results were compared with those of 167 healthy subjects matched for age and sex. Overall, patient seroconversion rate was 64·6%: serological response was lower in those receiving anti-cancer treatments in the 12 months before vaccination: 55% vs 81·9% (P < 0·001). Anti-CD20 antibody plus chemotherapy treatment was associated with the lowest seroconversion rate: 17·6% vs. 71·2% (P < 0·001). In the multivariate analysis conducted in the subgroup of patients on active treatment, independent predictors for seroconversion were: anti-CD20 treatment (P < 0·001), aggressive B-cell lymphoma diagnosis (P = 0·002), and immunoglobulin M levels <40 mg/dl (P = 0·030). The T-cell response was evaluated in 99 patients and detected in 85 of them (86%). Of note, 74% of seronegative patients had a T-cell response, but both cellular and humoral responses were absent in 13·1% of cases. Our findings raise some concerns about the protection that patients with LM, particularly those receiving anti-CD20 antibodies, may gain from vaccination. These patients should strictly maintain all the protective measures.
Keywords: COVID-19; Seroconversion; T-cell immune response; anti-CD20 antibody; lymphoid malignancies.
【저자키워드】 COVID-19, Seroconversion, T-cell immune response, Anti-CD20 antibody, lymphoid malignancies., 【초록키워드】 Treatment, mRNA vaccination, vaccination, antibody, T-cell Response, Prospective Study, Diagnosis, immune, Multiple myeloma, Humoral response, Measures, Immunoglobulin, B-cell lymphoma, lymphoma, Patient, T-cell, serological, anti-cancer treatment, anti-CD20, Protective, serological response, Anti-CD20 antibodies, cellular, Analysis, malignancy, increased mortality, anti-CD20 treatment, malignancies, seroconversion rate, lymphoid, Complete, raise, Chemotherapy treatment, lowest, Result, affected, evaluated, conducted, receiving, maintain, healthy subject, age and sex, independent predictor, seronegative patient, subgroup of patient, 【제목키워드】 immune response, SARS-CoV-2 vaccine, mRNA, Patient, T-cell, malignancy, lymphoid, absence,