Immune Response in 465 Hematological Patients Vaccinated with mRNA Vaccine Against SARS-CoV-2: A Single Centre Experience

For adult patients (pts) with hematologic malignancy and COVID-19, the risk of severe course is high and extensive preventive measures including vaccination should be considered. We report first data on 465 hematological pts vaccinated against COVID-19.We used the BNT 162b2 COMIRNATY mRNA vaccine (Pfizer/BioNTech) in a 21-day, two-dose schedule. We drew blood samples (ELISA anti-S IgG, IgA, IgM and in-house Virus Neutralisation Test) on Day 1, Day 22 and 14-28 days after second dose. IgG and/or IgA ≥1.1 and/or VNT ≥20 after the second dose were determined positive response. We correlated our data with sex, age, hematological diagnosis, treatment status and type. We excluded 101 pts with positive serology on Day 1 from our evaluation.Of 364 serologically COVID-naïve pts, 120 had lymphoma with 55.8% (67/120) response, 11.7% (5/43) in pts on anti-CD20 treatment. No active treatment shows better response for univariate analysis (83.8 % vs. 19.2 %, respectively; adjusted OR, 21.76; 95% CI, 8.84–59.03; p<0.001). Of 109 Multiple Myeloma pts, 90.8% (99/109) received active therapy, 72.4% (79/109) had immunoparesis and 30.3% (33/109) received anti-CD38 therapy with a response of 85.3% (93/109), 81% (64/79) and 81.8% (27/33), respectively for univariate analysis (adjusted OR, 0.68; 95% CI, 0.23–2.17; p=0.498). In 51 CLL pts we saw 39.2% (20/51) response, 90.3% (28/31) for Acute leukemia and 94.3% (50/53) forChronic myeloproliferative neoplasms (cMPN). Joint response for anti-CD20 in CLL and lymphoma was 13.7% (7/51).Our results show a significantly better response for Acute leukemia and cMPN with an impaired response in patients receiving anti-CD20 therapy. However, protective titers of IgG, IgA and VNT have not been determined yet and should be subject to further discussion.Funding Information: This work has been supported by the European Regional Development Fund—Project ENOCH (No. CZ.02.1.01/0.0/0.0/16_019/0000868).Declaration of Interests: All authors have nothing to declare. Ethics Approval Statement: This study was approved by the Ethical Committee of University hospital Ostrava, Czech Republic.