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Patients with treated indolent lymphomas immunized with BNT162b2 have reduced anti-spike neutralizing IgG to SARS-CoV-2 variants, but preserved antigen-specific T cell responses.
Beaton, Brendan; Sasson, Sarah C; Rankin, Katherine; Raedemaeker, Juliette; Wong, Alexander; Hastak, Priyanka; Phetsouphanh, Chansavath; Warden, Andrew; Klemm, Vera; Munier, C Mee Ling; Hoppe, Alexandra Carey; Tea, Fiona; Pillay, Aleha; Stella, Alberto Ospina; Aggarwal, Anupriya; Lavee, Orly; Caterson, Ian D; Turville, Stuart; Kelleher, Anthony D; Brilot, Fabienne; Trotman, Judith.
Afiliação
  • Beaton B; Haematology Department, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
  • Sasson SC; Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
  • Rankin K; The Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia.
  • Raedemaeker J; Department of Clinical Immunology and Immunopathology, ICPMR Westmead Hospital, Sydney, New South Wales, Australia.
  • Wong A; Haematology Department, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
  • Hastak P; Haematology Department, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
  • Phetsouphanh C; Haematology Department, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
  • Warden A; Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
  • Klemm V; The Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia.
  • Munier CML; The Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia.
  • Hoppe AC; WMozzies: Australian Patient Support Group for Waldenström's Macroglobulinemia, Sydney, New South Wales, Australia.
  • Tea F; The Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia.
  • Pillay A; The Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia.
  • Stella AO; The Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia.
  • Aggarwal A; Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
  • Lavee O; Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
  • Caterson ID; The Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia.
  • Turville S; The Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia.
  • Kelleher AD; St Vincent's Hospital, Sydney, New South Wales, Australia.
  • Brilot F; COVID Vaccination Hub, Sydney Local Health District, Sydney, New South Wales, Australia.
  • Trotman J; The Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia.
Am J Hematol ; 98(1): 131-139, 2023 01.
Article em En | MEDLINE | ID: mdl-35607995
ABSTRACT
Patients with indolent lymphoma undertaking recurrent or continuous B cell suppression are at risk of severe COVID-19. Patients and healthy controls (HC; N = 13) received two doses of BNT162b2 follicular lymphoma (FL; N = 35) who were treatment naïve (TN; N = 11) or received immunochemotherapy (ICT; N = 23) and Waldenström's macroglobulinemia (WM; N = 37) including TN (N = 9), ICT (N = 14), or treated with Bruton's tyrosine kinase inhibitors (BTKi; N = 12). Anti-spike immunoglobulin G (IgG) was determined by a high-sensitivity flow-cytometric assay, in addition to live-virus neutralization. Antigen-specific T cells were identified by coexpression of CD69/CD137 and CD25/CD134 on T cells. A subgroup (N = 29) were assessed for third mRNA vaccine response, including omicron neutralization. One month after second BNT162b2, median anti-spike IgG mean fluorescence intensity (MFI) in FL ICT patients (9977) was 25-fold lower than TN (245 898) and HC (228 255, p = .0002 for both). Anti-spike IgG correlated with lymphocyte count (r = .63; p = .002), and time from treatment (r = .56; p = .007), on univariate analysis, but only with lymphocyte count on multivariate analysis (p = .03). In the WM cohort, median anti-spike IgG MFI in BTKi patients (39 039) was reduced compared to TN (220 645, p = .0008) and HC (p < .0001). Anti-spike IgG correlated with neutralization of the delta variant (r = .62, p < .0001). Median neutralization titer for WM BTKi (0) was lower than HC (40, p < .0001) for early-clade and delta. All cohorts had functional T cell responses. Median anti-spike IgG decreased 4-fold from second to third dose (p = .004). Only 5 of 29 poor initial responders assessed after third vaccination demonstrated seroconversion and improvement in neutralization activity, including to the omicron variant.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Linfoma não Hodgkin / COVID-19 Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Linfoma não Hodgkin / COVID-19 Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article