TY - JOUR
T1 - Efficacy of the BNT162b2 mRNA COVID-19 vaccine in patients with B-cell non-Hodgkin lymphoma
AU - Perry, C.
AU - Luttwak, E.
AU - Balaban, R.
AU - Shefer, G.
AU - Morales, M. M.
AU - Aharon, A.
AU - Tabib, Y.
AU - Cohen, Y. C.
AU - Benyamini, N.
AU - Beyar-Katz, O.
AU - Neaman, M.
AU - Vitkon, R.
AU - Keren-Khadmy, N.
AU - Levin, M.
AU - Herishanu, Y.
AU - Avivi, I.
N1 - Publisher Copyright:
© 2021 American Society of Hematology. All rights reserved.
PY - 2021/8/24
Y1 - 2021/8/24
N2 - Patients diagnosed with B-cell non-Hodgkin lymphoma (B-NHL), particularly if recently treated with anti-CD20 antibodies, are at risk of severe COVID-19 disease. Because studies evaluating humoral response to COVID-19 vaccine in these patients are lacking, recommendations regarding vaccination strategy remain unclear. The humoral immune response to BNT162b2 messenger RNA (mRNA) COVID-19 vaccine was evaluated in patients with B-NHL who received 2 vaccine doses 21 days apart and compared with the response in healthy controls. Antibody titer, measured by the Elecsys Anti-SARS-CoV-2S assay, was evaluated 2 to 3 weeks after the second vaccine dose. Patients with B-NHL (n 5 149), aggressive B-NHL (a-B-NHL; 47%), or indolent B-NHL (i-B-NHL; 53%) were evaluated. Twenty-eight (19%) were treatment naïve, 37% were actively treated with a rituximab/ obinutuzumab (R/Obi) based induction regimen or R/Obi maintenance, and 44% had last been treated with R/Obi .6 months before vaccination. A seropositive response was achieved in 89%, 7.3%, and 66.7%, respectively, with response rates of 49% in patients with B-NHL vs 98.5% in 65 healthy controls (P , .001). Multivariate analysis revealed that longer time since exposure to R/Obi and absolute lymphocyte count $0.9 3 103/mL predicted a positive serological response. Median time to achieve positive serology among anti-CD20 antibody-Treated patients was longer in i-B-NHL vs a-B-NHL. The humoral response to BNT162b2 mRNA COVID-19 vaccine is impaired in patients with B-NHL who are undergoing R/Obi treatment. Longer time since exposure to R/Obi is associated with improved response rates to the COVID-19 vaccine. This study is registered at www.clinicaltrials.gov as #NCT04746092.
AB - Patients diagnosed with B-cell non-Hodgkin lymphoma (B-NHL), particularly if recently treated with anti-CD20 antibodies, are at risk of severe COVID-19 disease. Because studies evaluating humoral response to COVID-19 vaccine in these patients are lacking, recommendations regarding vaccination strategy remain unclear. The humoral immune response to BNT162b2 messenger RNA (mRNA) COVID-19 vaccine was evaluated in patients with B-NHL who received 2 vaccine doses 21 days apart and compared with the response in healthy controls. Antibody titer, measured by the Elecsys Anti-SARS-CoV-2S assay, was evaluated 2 to 3 weeks after the second vaccine dose. Patients with B-NHL (n 5 149), aggressive B-NHL (a-B-NHL; 47%), or indolent B-NHL (i-B-NHL; 53%) were evaluated. Twenty-eight (19%) were treatment naïve, 37% were actively treated with a rituximab/ obinutuzumab (R/Obi) based induction regimen or R/Obi maintenance, and 44% had last been treated with R/Obi .6 months before vaccination. A seropositive response was achieved in 89%, 7.3%, and 66.7%, respectively, with response rates of 49% in patients with B-NHL vs 98.5% in 65 healthy controls (P , .001). Multivariate analysis revealed that longer time since exposure to R/Obi and absolute lymphocyte count $0.9 3 103/mL predicted a positive serological response. Median time to achieve positive serology among anti-CD20 antibody-Treated patients was longer in i-B-NHL vs a-B-NHL. The humoral response to BNT162b2 mRNA COVID-19 vaccine is impaired in patients with B-NHL who are undergoing R/Obi treatment. Longer time since exposure to R/Obi is associated with improved response rates to the COVID-19 vaccine. This study is registered at www.clinicaltrials.gov as #NCT04746092.
UR - http://www.scopus.com/inward/record.url?scp=85113898393&partnerID=8YFLogxK
U2 - 10.1182/bloodadvances.2021005094
DO - 10.1182/bloodadvances.2021005094
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C2 - 34387648
AN - SCOPUS:85113898393
SN - 2473-9529
VL - 5
SP - 3053
EP - 3061
JO - Blood advances
JF - Blood advances
IS - 16
ER -
