Antibody, cell-mediated response and infection susceptibility in allogeneic hematopoietic stem cell recipients after COVID-19 mRNA vaccination.
Transpl Infect Dis
; 25(2): e14003, 2023 Apr.
Article
em En
| MEDLINE
| ID: mdl-36748718
ABSTRACT
BACKGROUND:
Patients undergoing allogeneic stem-cell transplantation (allo-SCT) have reduced responses to vaccines due to immunosuppressive status linked to GvHD prophylaxis and treatment. In our study, we compared humoral responses to anti-SARS-CoV-2 mRNA vaccine, and infection onset, according to patients and transplant features; we also evaluated cellular response in patients without seroconversion.METHODS:
We tested antibodies titer after second and third vaccine doses. Antibodies were detected through an immune-enzymatic assay. In a patients' subgroup without seroconversion, we tested cell-mediated responses evaluating interferon-gamma release by T-lymphocytes exposed to virus spike protein.RESULTS:
Seroconversion rate increased from 66% at 30 days to 81% at 90 days after the second dose; it was 97% at 150 days after the third dose. We found a significant association between seroconversion after the second dose and two variables shorter interval between allo-SCT and vaccination; ongoing immunosuppression. Twelve of 19 patients (63%) without antibodies after the second dose did not show cellular responses. Nineteen percent of patients developed SARS-CoV-2 infection after the third dose, with favorable outcome in all cases. Patients within 12 months after allo-SCT showed a significantly higher infection risk.CONCLUSIONS:
Our study suggests that an interval shorter than 12 months between allo-SCT and first vaccine dose and/or ongoing immunosuppression were associated with humoral and cellular response deficiency after two doses. Third dose induced an increased and sustained humoral response in the majority of patients. However, patients within 1 year after allo-SCT remained at higher infection risk and may be candidate for prophylaxis with anti-SARS-CoV-2 monoclonal antibodies.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
1_ASSA2030
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2_ODS3
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4_TD
Problema de saúde:
1_doencas_nao_transmissiveis
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1_doencas_transmissiveis
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2_enfermedades_transmissibles
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2_muertes_prematuras_enfermedades_notrasmisibles
/
4_pneumonia
Assunto principal:
Transplante de Células-Tronco Hematopoéticas
/
COVID-19
Limite:
Humans
Idioma:
En
Revista:
Transpl Infect Dis
Assunto da revista:
TRANSPLANTE
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Itália