Durable humoral responses after the second anti‐SARS‐CoV‐2 vaccine dose in chronic myeloid leukaemia patients on tyrosine kinase inhibitors

Claudiani, Simone; Apperley, Jane F.; Parker, Eleanor; Marchesin, Federica; Katsanovskaja, Ksenia; Palanicawandar, Renuka; Innes, Andrew; Tedder, Richard S.; McClure, Myra O.; Milojković, Dragana

doi:10.1111/bjh.18001

Cited by 16 publications

(17 citation statements)

References 11 publications

(18 reference statements)

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“…We also studied the association between TKI therapy and anti-spike IgG levels in CML patients. In accordance with literature, all CML patients have demonstrated to have a good serological response ( 16 , 17 ). We observed levels of antibodies greater in patients who had received second- and third-generation TKI than in patients who had used imatinib (11,301 vs .…”

Section: Resultssupporting

confidence: 88%

Evaluation of serological response to anti-SARS-CoV-2 mRNA vaccination in hematological patients

Pascale¹,

Nuccorini²,

Pierri³

et al. 2022

Front. Immunol.

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IntroductionIn immunocompromised patients, SARS-CoV-2 mRNA vaccine has been used in Italy from the beginning of the vaccination campaign, but several studies have shown that the serological response of onco-hematological patients was reduced compared to healthy subjects, due to the state of immunosuppression because of both underlying disease and administered therapy.MethodsWe evaluated the association of anti-SARS-CoV-2 spike IgG titers in 215 hematological patients with clinical and demographic variables to verify if it was possible to identify predictive parameters of serological response, as well as using a control group, consisting of healthy health workers of San Carlo Hospital in Potenza. Anti-SARS-CoV2 IgG titers were evaluated after 30–45 days post second dose vaccine using chemiluminescent microparticle immunoassay technology.ResultsPatients with hematological malignancies, compared with the control arm, had both a mean concentration of anti-SARS-CoV-2 IgG significantly lower and a seroconversion rate numerically lower. All chronic lymphatic leukemia patients showed levels of antibody titer below the mean concentration, also in only clinical surveillance patients. Comparing serological response in hematological malignancies, only acute leukemia patients who were off therapy had the highest seroconversion rate among the patients’ cohorts and a mean antibody concentration greater than the control arm. Patients treated with steroids and rituximab showed a lower level of anti-SARS-CoV-2 spike IgG. Differences in anti-spike IgG levels among chronic myeloid leukemia patients stratified according to tyrosine kinase inhibitor therapy and molecular response were observed, and they could have interesting implications on the evaluation of the effects of these drugs on the immune system, but having not reached statistical significance at the moment. The cohort of patients who received a stem cell transplant was very heterogeneous because it included different hematological malignancies and different types of transplant; however, a mean concentration of anti-SARS-CoV2 IgG greater than the control arm was reported. Indeed, among patients who performed a transplant for over 6 months only one had a spike IgG concentration below the cutoff.ConclusionsOur data confirm reduced serological response in hematological patients after anti-SARS-CoV-2 vaccination. However, we found a great diversity of SARS-CoV-2 antibody response according to types of pathologies and therapies.

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Section: Resultssupporting

confidence: 88%

Evaluation of serological response to anti-SARS-CoV-2 mRNA vaccination in hematological patients

Pascale¹,

Nuccorini²,

Pierri³

et al. 2022

Front. Immunol.

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“…Conversely, Claudiani et al. ( 25 ) found statistically insignificant differences in antibody titers between CML patients and healthy controls in their analysis.…”

Section: Resultsmentioning

confidence: 82%

“…malignancies and healthy controls (207.5 U/mL vs. 1078 U/mL). Conversely, Claudiani et al(25) found statistically insignificant differences in antibody titers between CML patients and healthy controls in their analysis.Other studies also mentioned the median antibody titers between subgroups of their cohorts. Active treatment of patients in a study byPerry et al (26) achieved lower antibodies when compared with treatment naive patients, although they were still lower compared to the healthy controls (13.7 U/mL, 1008 U/mL, and 1332 U/mL, respectively).…”

mentioning

confidence: 82%

Efficacy and safety profile of COVID-19 mRNA vaccine in patients with hematological malignancies: Systematic review and meta-analysis

Rinaldi

Pratama²,

Wiyono³

et al. 2022

Front. Oncol.

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Patient populations, including those with hematological malignancies, have different responses to COVID-19 vaccines. This study aimed to quantitatively analyze the efficacy and safety of COVID-19 mRNA vaccines in patients with hematological malignancies. Studies reporting on the efficacy and safety of COVID-19 mRNA vaccines in cohorts with hematological malignancies compared to healthy controls were systematically searched in four databases. Meta-analysis and subgroup analyses were performed to generate quantitative synthesis. Fifteen studies with 2,055 cohorts with hematological malignancies and 1,105 healthy subjects as control were included. After two doses of COVID-19 vaccination, only 60% of cohorts with hematological malignancies were seroconverted compared to healthy controls (RR 0.60; 95%CI 0.50–0.71). A single dose of the vaccine resulted in a significantly lower seroconversion rate (RR 0.30; 95%CI 0.16–0.54). Non-Hodgkin lymphoma cohorts had the lowest rate of seroconversion (RR 0.5; 95%CI 0.35–0.71) and those who received active treatments had lower immunological responses (RR 0.59; 95%CI 0.46–0.75). Antibody titers were lower in cohorts with hematological malignancies without any differences in adverse effects in both groups. In conclusion, cohorts with hematological malignancies showed a lower seroconversion rate and antibody titers after receiving COVID-19 mRNA vaccines. The type of malignancy and the status of treatment had a significant impact on the response to vaccination. The vaccines were shown to be safe for both patients with hematological malignancies and healthy controls. Booster doses and stricter health protocols might be beneficial for patient populations.

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“…Differences of age, screening practices, applied preventive methods for avoiding COVID-19 transmission, ethnicity, and comorbidities may be among the variables responsible from the discordance of mortality rates between studies. The COVID-19 vaccines were also studied in CML-CP and demonstrated robust immunologic activity in both humoral ( 8 ) and cellular ( 9 ) components following vaccination, dismissing concerns for impaired vaccine efficacy. Overall, the reviews concerning the issues mentioned above leave the impression that the presence of CML-CP was probably not a significant independent risk factor for severe COVID-19 or vaccine failure ( 10 , 11 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on the regular follow-up and outcomes of patients with chronic myeloid leukemia in chronic-phase

Yılmaz

Küçükyurt²,

Tunç³

et al. 2022

Front. Oncol.

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IntroductionCOVID-19 immediately became a major consideration in the management of chronic myeloid leukemia (CML). The influence of such considerations on viral transmission rates and leukemic control remain to be explored. We conducted this study to identify these alterations and to investigate their clinical consequences.MethodsThis was a cross-sectional study, performed at a single institution on CML patients who were interviewed with a survey. We compared variables concerning new attitudes in the pandemic era between the 12-month periods before and after the pandemic onset. Outcome data were attained from the hospital archives.FindingsThe number of patients receiving regular outpatient care for CML in chronic phase was 210, 91% had achieved at least major molecular responses. We assessed survival, progression, number of clinical visits of all, performed the survey on 89% and evaluated molecular responses on 86.6% of these patients. The frequency of clinical and molecular monitoring was significantly reduced during the pandemic deviating significantly from the guidelines. Frequency of death, progression, loss of molecular response was not significantly increased during the pandemic era despite a few cases where the delay in assessment possibly played a role in the unfavorable outcomes. There were no COVID related deaths or disabilities.ConclusionThe case-based untoward events would have probably been better managed with a more efficient communication web between patients, hematologists, and the laboratory. Therefore, it seems reasonable to consider whether such communicative paths are functional before giving up on the set schedule of CML management at times of uncertainty.

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Durable humoral responses after the second anti‐SARS‐CoV‐2 vaccine dose in chronic myeloid leukaemia patients on tyrosine kinase inhibitors

Cited by 16 publications

References 11 publications

Evaluation of serological response to anti-SARS-CoV-2 mRNA vaccination in hematological patients

Evaluation of serological response to anti-SARS-CoV-2 mRNA vaccination in hematological patients

Efficacy and safety profile of COVID-19 mRNA vaccine in patients with hematological malignancies: Systematic review and meta-analysis

Impact of the COVID-19 pandemic on the regular follow-up and outcomes of patients with chronic myeloid leukemia in chronic-phase

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