Cellular and humoral response to the fourth BNT162b2 mRNA COVID-19 vaccine dose in patients with CLL

Ohad Benjamini*, Rotem Gershon, Erez Bar-Haim, Yaniv Lustig, Hila Cohen, Ram Doolman, Meirav Kedmi, Elena Ribakovsky, Abraham Kneller, Tammy Hod, Noam Erez, Itzhak Levy, Galia Rahav, Abraham Avigdor

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

We assessed the humoral and cellular response to the fourth BNT162b2 mRNA COVID-19 vaccine dose in patients with CLL. A total of 67 patients with CLL and 85 age matched controls tested for serologic response and pseudo-neutralization assay. We also tested the functional T-cell response by interferon gamma (IFNγ) to spike protein in 26 patients. Two weeks after the fourth vaccine antibody serologic response was evident in 37 (55.2%) patients with CLL, 20 /22 (91%) of treatment naïve, and 9/32 (28%) patients with ongoing therapy, compared with 100% serologic response in age matched controls. The antibody titer increased by 10-fold in patients with CLL, however, still 88-folds lower than age matched controls. Predictors of better chances of post fourth vaccination serologic response were previous positive serologies after second, third, and pre-fourth vaccination, neutralizing assay, and treatment naïve patients. T-cell response improved from 42.3% before the fourth vaccine to 84.6% 2 weeks afterwards. During the time period of 3 months after the fourth vaccination, 14 patients (21%) developed COVID-19 infection, all recovered uneventfully. Our data demonstrate that fourth SARS-CoV-2 vaccination improves serologic response in patients with CLL to a lesser extent than healthy controls and induces functional T-cell response.

Original languageEnglish
Pages (from-to)99-108
Number of pages10
JournalEuropean Journal of Haematology
Volume110
Issue number1
DOIs
StatePublished - Jan 2023

Keywords

  • BNT162b2 mRNA
  • CLL
  • COVID-19
  • COVID-19 vaccine
  • booster
  • chronic lymphocytic leukemia
  • immune response

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