COVID-19 vaccination protects patients with B-cell lymphoma and multiple myeloma

People with hematological malignancies are at increased risk of severe coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, few studies have investigated the immune response to the COVID-19 vaccine.Recent natural cancer Studies have shown that patients with B-cell lymphoma (LY) and multiple myeloma (MM) developed potent infection-neutralizing abilities against several of concern SARS-CoV-2 variants (VoC). Recorded.

​​​​​​​study: Potent high avidity neutralizing antibody and T cell responses after COVID-19 vaccination in patients with B-cell lymphoma and multiple myelomaImage credit: Design_Cells / Shutterstock

About research

Cancer patients show high mortality and morbidity due to SARS-CoV-2 infection. Such people often develop secondary immunodeficiency and become seriously ill.Research has demonstrated efficacy of Induce both available vaccines that reduce disease severity in immunocompetent individuals T cells and humorous responses.

In the current study, we developed a longitudinal approach to study the T cell and humoral immune responses generated by two and three doses of vaccination, primarily using the BNT162b2 mRNA vaccine. A cohort of individuals had her LY and MM different her B cells.The researchers were able to obtain a complete picture of vaccine-induced immune responses in this group compared to healthy controls. Parallel and time-resolved assessment of antibody titers against the virus spike proteinneutralization capacity, and antibody avidity against six bona fide, replication-competent viruses, and T-cell responses directed against HCoV OC43 and SARS-CoV-2 were analyzed.

Main findings

The current study reports six key findings. First, compared to healthy individuals, individuals with hematologic malignancies had only a slightly lower ability to neutralize infection against SARS-CoV-2 variants. This was despite the much lower antibody titers against the spike protein in the treatment group.

Second, the neutralizing potency per unit of anti-spike antibody was significantly enhanced in patients with hematopoietic malignancies compared to controls (on average 20.8-fold). This enhancement was observed early after the second vaccination. Third, compared to healthy individuals, the treated group showed higher avidity of serum IgG binding to the viral spike protein before receiving the third dose of vaccine.

Fourth, omicron (BA.1) and to a lesser extent beta and delta VoC showed the greatest humoral escape. This finding was consistent with recent results on healthy individuals post-vaccination or post-infection. Fifth, an overwhelming proportion of study participants demonstrated strong vaccine-induced T cell responses to several recent VoCs. This group included participants with LY and receiving Rx therapy. Sixth, no COVID-19-related deaths were reported in the study cohort, and clinical manifestations during breakthrough infection suggest that the vaccine may provide partial protection to immunocompromised individuals with hematologic malignancies. Proven.

The results showed that LY patients without a humoral immune response were at increased risk of contracting symptomatic breakthrough infections. This highly immunosuppressed group may benefit from preexposure prophylaxis with neutralizing mAbs, although most currently available mAbs have shown loss of antiviral efficacy against her recent VoC. increase.

A third vaccination was observed to be important in both groups for increasing antibody titers. However, it was proposed that quality rather than quantity of spike-targeting antibodies is more important. Therefore, absolute doses may underestimate the efficacy of humoral responses in MM or LY vaccinees.

Studies have shown that mRNA-based vaccines induce spike-specific T cell responses in most healthy recipients. However, more heterogeneous responses have been reported in cancer patients. Results regarding vaccine-induced T-cell responses induced in 85% of hematological cancer patients included in the study were consistent with those reported in a large UK cancer cohort study. In the latter study, the response rate in a cohort of patients with hematological cancers was 80%.

Strengths and limitations of current research

A major strength of this study is the longitudinal sampling of clinically well-characterized cancer patients and subsequent matching with a group of healthy health care workers. Robust methodological approaches such as quantification of anti-spike IgG avidity and live virus neutralization assays are another strength of current research.

A significant limitation of this study is the small number of hematological cancer patients (N = 60). There were also no contemporaneous controls for solid tumors or other hematologic malignancies. In addition, no adjustment was made for multiple tests of correlation analysis that may have introduced confounding factors.

Conclusion

More detailed longitudinal studies of COVID-19 immunity induced by infection and vaccine should use multiparameter assessment. This is important for a better understanding of quantitative markers as correlates of protection for individuals with hematologic malignancies as new SARS-CoV-2 VoCs emerge.