Humoral and cellular responses after a third dose of SARS-CoV-2 BNT162b2 vaccine in patients with lymphoid malignancies

Daniel Re,Daisy Graça,Benjamin Verrière,Sylvia Benzaken,Emmanuel Chamorey,Michel Carles,Daisy Graça,Khaled Zahreddine,Sylvia Benzaken,Béatrice Bailly-Maitre,Béatrice Bailly-Maitre,Vesna Brglez,Vesna Brglez,Vesna Brglez,Daisy Graça,Barbara Seitz-Polski,Barbara Seitz-Polski,Barbara Seitz-Polski,Sylvia Benzaken,Stéphane Liguori,Margaux Delforge,Jérôme Barrière

doi:10.1038/s41467-022-28578-0

Abstract

Patients with hematological malignancies have impaired immune response after two doses of BNT162b2 (Pfizer/BioNTech) vaccine against SARS-CoV-2. Here, in this observational study (registration number HDH F20210324145532), we measure SARS-CoV-2 anti-Spike antibodies, neutralizing antibodies and T-cell responses after immune stimulation with a third dose (D3) of the same vaccine in patients with chronic lymphocytic leukemia (n = 13), B cell non-Hodgkin lymphoma (n = 14), and multiple myeloma (n = 16)). No unexpected novel side effects are reported. Among 25 patients with positive anti-S titers before D3, 23 (92%) patients increase their anti-S and neutralizing antibody titer after D3. All 18 (42%) initially seronegative patients remain negative. D3 increases the median IFN-γ secretion in the whole cohort and induces IFN-γ secretion in a fraction of seronegative patients. Our data thus support the use of a third vaccine dose amongst patients with lymphoid malignancies, even though some of them will still have vaccine failure.

Highlights

Patients with hematological malignancies have impaired immune response after two doses of BNT162b2 (Pfizer/BioNTech) vaccine against SARS-CoV-2
Some of these treatments such as monoclonal B-cell depleting anti-CD20 antibodies are known to alter patient’s immune response and sometimes durably. This is highlighted by the observation that vaccination against SARS-CoV-2 is less effective in immunocompromised patients such as organ transplanted patients[3], patients treated for SC4–6 or patients with hematological malignancies (HM) and especially patients with chronic lymphocytic leukemia (CLL)[7,8,9] in comparison to a healthy population
In view of the altered immune response of patients suffering from HM we decide to conduct a specific observatory of patients followed at our hospital for lymphoid malignancies (LM) after vaccination with two doses of the SARS-CoV-2 mRNA BNT162b2 vaccine (Pfizer / BioNtech)

Summary

Introduction

Patients with hematological malignancies have impaired immune response after two doses of BNT162b2 (Pfizer/BioNTech) vaccine against SARS-CoV-2. Some of these treatments such as monoclonal B-cell depleting anti-CD20 antibodies are known to alter patient’s immune response and sometimes durably. This is highlighted by the observation that vaccination against SARS-CoV-2 is less effective in immunocompromised patients such as organ transplanted patients[3], patients treated for SC4–6 or patients with HM and especially patients with chronic lymphocytic leukemia (CLL)[7,8,9] in comparison to a healthy population. The possibility to boost cellular responses in patients without antibody response has to be considered when proposing novel vaccine strategies to immunocompromised patients

Methods

Results

Conclusion