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Cellular and humoral immunogenicity of the mRNA-1273 SARS-CoV-2 vaccine in patients with hematologic malignancies. 2022
Moraima Jiménez, and
Elisa Roldán, and
Candela Fernández-Naval, and
Guillermo Villacampa, and
Mónica Martinez-Gallo, and
Daniel Medina-Gil, and
Soraya Peralta-Garzón, and
Gemma Pujadas, and
Cristina Hernández, and
Carlota Pagès, and
Mercedes Gironella, and
Laura Fox, and
Guillermo Orti, and
Pere Barba, and
Tomás Pumarola, and
Alba Cabirta, and
Eva Catalá, and
Mercedes Valentín, and
Ana Marín-Niebla, and
Alberto Orfao, and
Marcos González, and
Magda Campins, and
Isabel Ruiz-Camps, and
David Valcárcel, and
Francesc Bosch, and
Manuel Hernández, and
Marta Crespo, and
Juliana Esperalba, and
Pau Abrisqueta
Servei d'Hematologia, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
Recent studies have shown a suboptimal humoral response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in patients diagnosed with hematologic malignancies; however, data about cellular immunogenicity are scarce. The aim of this study was to evaluate both the humoral and cellular immunogenicity 1 month after the second dose of the mRNA-1273 vaccine. Antibody titers were measured by using the Elecsys and LIAISON anti-SARS-CoV-2 S assays, and T-cell response was assessed by using interferon-γ release immunoassay technology. Overall, 76.3% (184 of 241) of patients developed humoral immunity, and the cellular response rate was 79% (184 of 233). Hypogammaglobulinemia, lymphopenia, active hematologic treatment, and anti-CD20 therapy during the previous 6 months were associated with an inferior humoral response. Conversely, age >65 years, active disease, lymphopenia, and immunosuppressive treatment of graft-versus-host disease (GVHD) were associated with an impaired cellular response. A significant dissociation between the humoral and cellular responses was observed in patients treated with anti-CD20 therapy (the humoral response was 17.5%, whereas the cellular response was 71.1%). In these patients, B-cell aplasia was confirmed while T-cell counts were preserved. In contrast, humoral response was observed in 77.3% of patients undergoing immunosuppressive treatment of GVHD, whereas only 52.4% had a cellular response. The cellular and humoral responses to the SARS-CoV-2 mRNA-1273 vaccine in patients with hematologic malignancies are highly influenced by the presence of treatments such as anti-CD20 therapy and immunosuppressive agents. This observation has implications for the further management of these patients.
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