Single dose of BNT162b2 mRNA vaccine against severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) induces neutralising antibody and polyfunctional T‐cell responses in patients with chronic myeloid leukaemia

Abstract

Summary Patients receiving targeted cancer treatments such as tyrosine kinase inhibitors (TKIs) have been classified in the clinically extremely vulnerable group to develop severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), including patients with chronic myeloid leukaemia (CML) taking TKIs. In addition, concerns that immunocompromised individuals with solid and haematological malignancies may not mount an adequate immune response to a single dose of SARS‐CoV‐2 BNT162b2 (Pfizer‐BioNTech) vaccine have been raised. In the present study, we evaluated humoral and cellular immune responses after a first injection of BNT162b2 vaccine in 16 patients with CML. Seroconversion and cellular immune response before and after vaccination were assessed. By day 21 after vaccination, anti‐Spike immunoglobulin G was detected in 14/16 (87·5%) of the patients with CML and all developed a neutralising antibody response [serum dilution that inhibits 50% infection (ID 50 ) >50], including medium (ID 50 of 200–500) or high (ID 50 of 501–2000) neutralising antibodies titres in nine of the 16 (56·25%) patients. T‐cell response was seen in 14/15 (93·3%) evaluable patients, with polyfunctional responses seen in 12/15 (80%) patients (polyfunctional CD4 + response nine of 15, polyfunctional CD8 + T‐cell response nine of 15). These data demonstrate the immunogenicity of a single dose of SARS‐CoV‐2 BNT162b2 vaccine in most patients with CML, with both neutralising antibodies and polyfunctional T‐cell responses seen in contrast to patients with solid tumour or lymphoid haematological malignancies.

Immunogenicity and risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection after Coronavirus Disease 2019 (COVID-19) vaccination in patients with cancer: a systematic review and meta-analysis

“…Following title and abstract review, 1,233 records were excluded given that they reported non-original findings, did not include cancer patients, or did not assess COVID-19 vaccines’ immunogenicity. Of the 54 articles that underwent full-text review, 35 articles[ [17] , [18] , [19] , [20] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] ] were considered eligible and were included in the meta-analysis ( Figure 1 ).

Figure 1 The PRISMA flowchart summarizing the process for the identification of eligible studies.

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“…Of the included 35 studies, 20 reported the seroconversion rate in cancer patients after partial COVID-19 immunization (2574 patients)[ 17 , 20 , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , 37 , [42] , [43] , [44] , [47] , [48] , [49] , [50] , [51] , [52] ] and 24 after complete vaccination schemes (4708 patients). [ [17] , [18] , [19] , [20] , 27 , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , 45 , 46 , 48 , 49 , 53 , 54 ] A lower seroconversion rate was achieved by those with incomplete vaccination regimens (51%; 95%CI 41-62) compared to those with fully immunized patients (73%; 95%CI 64-81) ( P =0.0009) ( Figure 2 ).…”

“…A pooled analysis of 6 studies[ 20 , 25 , 26 , 39 , 40 , 54 ] including 84 patients with incomplete and 634 with complete vaccination regimens showed that 78% (95%CI 30-97) and 60% (95%CI 30-84) developed an adequate T-cell response, respectively ( Supplemental eFigure 4 ).…”

Antibody Responses to COVID-19 Vaccination in Cancer: A Systematic Review

“…Most studies (18/27) included a control group which involved mostly health care workers. Seven studies included only patients with solid tumors ( 22 , 25 , 27 , 32 , 34 , 36 , 39 ), four studies included both solid tumor patients and patients with hematologic malignancies ( 28 , 33 , 40 , 41 ) and 16 studies included only patients with hematologic malignancies ( 24 , 26 , 29 – 31 , 35 , 37 , 38 , 42 – 49 ). Nine studies included both patients in remission and patients under active treatment.…”

“…Nine studies included both patients in remission and patients under active treatment. Twelve studies measured baseline anti-SARS-CoV-2 antibodies and excluded patients with positive baseline antibody titers ( 27 – 30 , 33 , 37 – 39 , 41 , 44 , 48 , 49 ).Eight studies used only previous COVID-19 history as the exclusion criteria ( 24 , 25 , 31 , 34 – 36 , 43 , 46 )and 4 studies included patients with previous COVID-19 history ( 22 , 26 , 40 , 42 ). The antibody measurement methods were very heterogenous between the studies and immunoglobulin G (IgG) antibodies against the SARS-CoV-2 spike protein were the most commonly used antibody assay ( Table 2 ).…”