Open AccessEfficacy of the BNT162b2 mRNA COVID-19 Vaccine in Patients with Chronic Lymphocytic Leukemia: A Serologic and Cellular Study
Author(s) -
Stefano Molica,
Diana Giannarelli,
Mirella Lentini,
Daniela Zappalà,
A Mannella,
Daniela Loiacono,
Valentina Gianfelici,
Giuseppina Panduri,
Iris Gariani,
Pasquale Minchella,
Francesco Talarico,
Luciano Levato
Publication year - 2021
Publication title -
chemotherapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.539
H-Index - 54
eISSN - 1421-9794
pISSN - 0009-3157
DOI - 10.1159/000521229
Subject(s) - medicine , serology , vaccination , chronic lymphocytic leukemia , immunology , antibody , immune system , cd20 , leukemia
Background: Antibody response following SARS-CoV-2 vaccination is somewhat defective in chronic lymphocytic leukemia (CLL). Moreover, the correlation between serologic response and status of cellular immunity has been poorly studied. Objective: This study was undertaken to assess humoral immune and cellular responses to the BNT162b2 messenger RNA (mRNA) COVID-19 vaccination in CLL. Methods: The presence of the spike antibodies was assessed at a median time of 14 days from the second vaccine dose of SARS-CoV-2 in 70 CLL patients followed up at a single institution. Results: The antibody response rate (RR) in CLL patients was 58.5%, compared to 100% of 57 healthy controls of the same sex and age (p < 0.0001). Treatment-naïve patients and those in sustained clinical remission after therapy had the highest RR (87.0% and 87.7%, respectively). In contrast, patients on therapy with a pathway inhibitor as monotherapy and those treated with an association of anti-CD20 antibody were unlikely to respond to the SARS-CoV-2 vaccine (52% and 10%, respectively). In multivariate analysis, early Rai stage (OR, 0.19 [0.05–0.79]; p = 0.02) and no previous therapy (OR, 0.06 [0.02–0.27]; p < 0.0001) were found to be independent predictors of vaccination response. An increase in absolute NK cells (i.e., CD16/CD56 positive cells) in patients with a serological response was found following the second dose of vaccine (p = 0.02). Conclusions: These results confirm that serological response to the BNT162b2 vaccine in patients with CLL is impaired. A third boosting vaccine dosage should be considered for these patients.