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Seroconversion to mRNA SARS-CoV-2 Vaccines in Hematologic Patients
Hematologic patients show lower responses to SARS-CoV-2 vaccines, but predictors of seroconversion are lacking. In this prospective cohort study, hematologic patients undergoing SARS-CoV-2 mRNA vaccination at a single center in Milan, Italy, were sampled for anti-Spike and anti-Nucleocapsid IgG tite...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9133475/ https://www.ncbi.nlm.nih.gov/pubmed/35634287 http://dx.doi.org/10.3389/fimmu.2022.852158 |
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author | Fattizzo, Bruno Bortolotti, Marta Rampi, Nicolò Cavallaro, Francesca Giannotta, Juri Alessandro Bucelli, Cristina Cassin, Ramona Da Vià, Matteo Claudio Galassi, Giulia Noto, Alessandro Pettine, Loredana Rossi, Francesca Gaia Sciumè, Mariarita Ceriotti, Ferruccio Consonni, Dario Barcellini, Wilma Baldini, Luca |
author_facet | Fattizzo, Bruno Bortolotti, Marta Rampi, Nicolò Cavallaro, Francesca Giannotta, Juri Alessandro Bucelli, Cristina Cassin, Ramona Da Vià, Matteo Claudio Galassi, Giulia Noto, Alessandro Pettine, Loredana Rossi, Francesca Gaia Sciumè, Mariarita Ceriotti, Ferruccio Consonni, Dario Barcellini, Wilma Baldini, Luca |
author_sort | Fattizzo, Bruno |
collection | PubMed |
description | Hematologic patients show lower responses to SARS-CoV-2 vaccines, but predictors of seroconversion are lacking. In this prospective cohort study, hematologic patients undergoing SARS-CoV-2 mRNA vaccination at a single center in Milan, Italy, were sampled for anti-Spike and anti-Nucleocapsid IgG titer at 5 ± 1 weeks and at 3 months from the second vaccine dose. Patients (N = 393) received either BNT162b2 (Pfizer-BioNTech, 48%) or MRNA-1273 (Moderna, 52%), and 284 (72%) seroconverted and 100% persisted at 3 months. Non-response was higher in chronic lymphocytic leukemia (CLL) and lymphoma patients, and in those treated with small molecules and monoclonal antibodies. In myeloid neoplasms, lower responses were detected in patients with acute myeloid leukemia treated with venetoclax plus hypomethylating agents and in patients with myelofibrosis receiving ruxolitinib. Multivariable analysis showed that seroconversion was favorably associated with a diagnosis other than indolent lymphoma/CLL [OR 8.5 (95% CI 4.1–17.6)], lack of B-cell-depleting therapy [OR 3.15 (1.7–5.9)], and IgG levels within the normal range [OR 2.2 (1.2–4.2)]. We developed a simple algorithm according to these 3 risk factors [(A) diagnosis of indolent lymphoma/CLL, (B) B-cell-depleting treatment, and (C) low IgG] to predict non-response. IgG levels and treatment may be modifiable risk factors and should be considered for timing of vaccine administration. |
format | Online Article Text |
id | pubmed-9133475 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-91334752022-05-27 Seroconversion to mRNA SARS-CoV-2 Vaccines in Hematologic Patients Fattizzo, Bruno Bortolotti, Marta Rampi, Nicolò Cavallaro, Francesca Giannotta, Juri Alessandro Bucelli, Cristina Cassin, Ramona Da Vià, Matteo Claudio Galassi, Giulia Noto, Alessandro Pettine, Loredana Rossi, Francesca Gaia Sciumè, Mariarita Ceriotti, Ferruccio Consonni, Dario Barcellini, Wilma Baldini, Luca Front Immunol Immunology Hematologic patients show lower responses to SARS-CoV-2 vaccines, but predictors of seroconversion are lacking. In this prospective cohort study, hematologic patients undergoing SARS-CoV-2 mRNA vaccination at a single center in Milan, Italy, were sampled for anti-Spike and anti-Nucleocapsid IgG titer at 5 ± 1 weeks and at 3 months from the second vaccine dose. Patients (N = 393) received either BNT162b2 (Pfizer-BioNTech, 48%) or MRNA-1273 (Moderna, 52%), and 284 (72%) seroconverted and 100% persisted at 3 months. Non-response was higher in chronic lymphocytic leukemia (CLL) and lymphoma patients, and in those treated with small molecules and monoclonal antibodies. In myeloid neoplasms, lower responses were detected in patients with acute myeloid leukemia treated with venetoclax plus hypomethylating agents and in patients with myelofibrosis receiving ruxolitinib. Multivariable analysis showed that seroconversion was favorably associated with a diagnosis other than indolent lymphoma/CLL [OR 8.5 (95% CI 4.1–17.6)], lack of B-cell-depleting therapy [OR 3.15 (1.7–5.9)], and IgG levels within the normal range [OR 2.2 (1.2–4.2)]. We developed a simple algorithm according to these 3 risk factors [(A) diagnosis of indolent lymphoma/CLL, (B) B-cell-depleting treatment, and (C) low IgG] to predict non-response. IgG levels and treatment may be modifiable risk factors and should be considered for timing of vaccine administration. Frontiers Media S.A. 2022-05-12 /pmc/articles/PMC9133475/ /pubmed/35634287 http://dx.doi.org/10.3389/fimmu.2022.852158 Text en Copyright © 2022 Fattizzo, Bortolotti, Rampi, Cavallaro, Giannotta, Bucelli, Cassin, Da Vià, Galassi, Noto, Pettine, Rossi, Sciumè, Ceriotti, Consonni, Barcellini and Baldini https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Immunology Fattizzo, Bruno Bortolotti, Marta Rampi, Nicolò Cavallaro, Francesca Giannotta, Juri Alessandro Bucelli, Cristina Cassin, Ramona Da Vià, Matteo Claudio Galassi, Giulia Noto, Alessandro Pettine, Loredana Rossi, Francesca Gaia Sciumè, Mariarita Ceriotti, Ferruccio Consonni, Dario Barcellini, Wilma Baldini, Luca Seroconversion to mRNA SARS-CoV-2 Vaccines in Hematologic Patients |
title | Seroconversion to mRNA SARS-CoV-2 Vaccines in Hematologic Patients |
title_full | Seroconversion to mRNA SARS-CoV-2 Vaccines in Hematologic Patients |
title_fullStr | Seroconversion to mRNA SARS-CoV-2 Vaccines in Hematologic Patients |
title_full_unstemmed | Seroconversion to mRNA SARS-CoV-2 Vaccines in Hematologic Patients |
title_short | Seroconversion to mRNA SARS-CoV-2 Vaccines in Hematologic Patients |
title_sort | seroconversion to mrna sars-cov-2 vaccines in hematologic patients |
topic | Immunology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9133475/ https://www.ncbi.nlm.nih.gov/pubmed/35634287 http://dx.doi.org/10.3389/fimmu.2022.852158 |
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