Abstract
The cellular response to SARS-CoV-2 vaccination and infection in allogeneic hematopoietic stem cell transplant (HSCT) recipients is not yet clear. In the current study, HSCT recipients prior to and post vaccination were tested for SARS-CoV-2-specific humoral and cellular immunity. Antibodies against spike (S) 1 were assessed by Anti-SARS-CoV-2 IgG ELISA (Euroimmun). Cellular immunity was analyzed by an in house interferon-gamma ELISpot and T-SPOT.COVID (Oxford Immunotec), using altogether seven SARS-CoV-2-specific antigens. In 117 HSCT patients vaccinated twice, SARS-CoV-2 IgG antibodies were significantly higher than in HSCT controls pre vaccination (p < 0.0001). After the second vaccination, we observed a median antibody ratio of 4.7 and 68% positive results, whereas 35 healthy controls reached a median ratio of 9.0 and 100% positivity. ELISpot responses in patients were significantly (p < 0.001) reduced to ≤33% of the controls. After the second vaccination, female HSCT patients and female healthy controls showed significantly higher antibody responses than males (6.0 vs. 2.1 and 9.2 vs. 8.2, respectively; p < 0.05). Cellular immunity was diminished in patients irrespective of sex. In conclusion, especially male HSCT recipients showed impaired antibody responses after SARS-CoV-2 vaccination. Changing the vaccine schedule or composition could help increase vaccine responses.
Highlights
The severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has caused a pandemic worldwide, and the clinical course of the disease shows substantial variation.Recent reports suggested that patients with hematological disorders such as leukemia, lymphoma and autologous or allogeneic hematopoietic stem cell transplantation (HSCT)had a higher risk of contracting SARS-CoV-2 than the general population, and infected people have a higher mortality rate [1]
In 117 HSCT patients vaccinated twice against SARS-CoV-2, IgG antibody levels directed against the S1 antigen were significantly lower than in 35 healthy controls
The observed differences between HSCT patients and healthy controls cannot be attributed to the different SARS-CoV-2 vaccines used
Summary
The severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has caused a pandemic worldwide, and the clinical course of the disease shows substantial variation.Recent reports suggested that patients with hematological disorders such as leukemia, lymphoma and autologous or allogeneic hematopoietic stem cell transplantation (HSCT)had a higher risk of contracting SARS-CoV-2 than the general population, and infected people have a higher mortality rate [1]. Recent reports suggested that patients with hematological disorders such as leukemia, lymphoma and autologous or allogeneic hematopoietic stem cell transplantation (HSCT). Vaccinations against SARS-CoV-2 may prevent infection, its effectiveness needs to be proven in this immunocompromised cohort. In patients vaccinated after hematopoietic stem cell transplantation, specific antibody responses were impaired [2,3,4]. We report on a large, twice vaccinated HSCT cohort (n = 117), in which T cell immunity against SARS-CoV-2 was analyzed by interferon (IFN)-γ ELISpot, using seven SARS-CoV-2-specific antigens. We analyzed if covariates, such as sex, age or interval between HSCT, vaccination or infection and testing, had an impact on SARS-CoV-2-specific immunity
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