Non-Myelofibrosis Chronic Myeloproliferative Neoplasm Patients Show Better Seroconversion Rates after SARS-CoV-2 Vaccination Compared to Other Hematologic Diseases: A Multicentric Prospective Study of KroHem

Abstract

Disease- and treatment-mediated immunodeficiency might render SARS-CoV-2 vaccines less effective in patients with hematologic diseases. We performed a prospective non-interventional study to evaluate humoral response after one and two doses of mRNA-1273, BNT162b2, or ChAdOx1 nCoV-19 vaccine in 118 patients with different malignant or non-malignant hematologic diseases from three Croatian treatment centers. An electrochemiluminescent assay was used to measure total anti-SARS-CoV-2 S-RBD antibody titers. After one vaccine dose, 20/66 (33%) achieved seropositivity with a median antibody titer of 6.1 U/mL. The response rate (58/90, 64.4%) and median antibody titer (>250 U/mL) were higher after two doses. Seropositivity varied with diagnosis (overall p < 0.001), with the lowest rates in lymphoma (34.6%) and chronic lymphocytic leukemia (52.5%). The overall response rate in chronic myeloproliferative neoplasms (CMPN) was 81.3% but reached 100% in chronic myeloid leukemia and other non-myelofibrosis CMPN. At univariable analysis, age > 67 years, non-Hodgkin’s lymphoma, active treatment, and anti-CD20 monoclonal antibody therapy increased the likelihood of no vaccine response, while hematopoietic stem cell recipients were more likely to respond. Age and anti-CD20 monoclonal antibody therapy remained associated with no response in a multivariable model. Patients with the hematologic disease have attenuated responses to SARS-CoV-2 vaccines, and significant variations in different disease subgroups warrant an individualized approach.

Treatment-Related Risk Factors for Adverse Outcomes of COVID-19 in Patients Treated for Lymphoid Malignancies in the Pre-Omicron Era—A Study of KroHem, the Croatian Group for Hematologic Diseases

“…Vaccination against COVID-19 started in Croatia in December 2020, and most patients received the second dose in the beginning of 2021. Since the majority of patients on treatment for lymphoid neoplasms fail to raise adequate humoral responses [25][26][27][28][29], it seems reasonable to conclude that almost all of the analyzed patients were unprotected against the infection. All of this explains the high mortality rate, different from the current situation, but similar to that of other contemporary series [3,4].…”

Relationship of Anxiety, Depression, Stress, and Post-Traumatic Stress Disorder Symptoms with Disease Severity in Acutely Ill Hospitalized COVID-19 Patients

“…The median score for anxiety symptoms was 8 points, IQR (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Anxiety sym were absent in 74 (43.8%), mild in 11 (6.5%), moderate in 29 (17.2%), severe in 9 ( and extremely severe in 46 (27.2%) patients.…”

“…Subsequent vaccination program and occurrence of novel, less aggressive viral strains significantly reduced the number of patients presenting with severe and critical forms of the disease. Despite benefits of vaccination, even among those with breakthrough infections [ 4 ], vaccine hesitancy, inadequate immunization among elderly and immunosuppressed patients, as well as waning effects of vaccine-induced immunization remain substantial problems for global control of the COVID-19 pandemic [ 5 , 6 ].…”