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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
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.
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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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