Humoral and cellular responses to SARS-CoV-2 vaccination in patients with lymphoid malignancies

This research has not been peer-reviewed. It is a preliminary report that should not be regarded as conclusive, guide clinical practice or health-related behaviour, or be reported in news media as established information.

SARS-CoV-2 vaccination protects against COVID-19. Antibodies and antigen-specific T-cell responses against the spike domain can be used to measure vaccine immune response. Individuals with lymphoma have defects in humoral and cellular immunity that may compromise vaccine response. In this prospective observational study of 457 participants with lymphoma, 52% of participants vaccinated on treatment had undetectable anti-spike IgG antibodies compared to 9% who were not on treatment. Marked impairment was observed in those receiving anti- CD20 antibody within 12 months where 60% had undetectable antibodies compared to 11% on chemotherapy, which persisted despite three vaccine doses. Overall, 63% had positive T-cell responses irrespective of treatment. Individuals with indolent B-cell lymphoma have impaired antibody and cellular responses that were independent of treatment. The significant reduction and heterogeneity in immune responses in these individuals emphasise the urgent need for immune response monitoring and alternative prophylactic strategies to protect against COVID- 19.

Author list

Sean H. Lim, Nicola Campbell, Beth Stuart, Marina Johnson, Debora Joseph-Pietras, Adam Kelly, Danielle Jeffrey, Anna H. Turaj, Kate Rolfvondenbaumen, Celine Galloway, Thomas Wynn, Adam R. Coleman, Benjamin Ward, Karen Long, Andrew T. Bates, Diana Ayres, Robert Lown, Janlyn Falconer, Oliver Brake, James Batchelor, Victoria Willimott, Anna Bowzyk Al-Naeeb, Lisa Robinson, Ann O’Callaghan, Graham P. Collins, Tobias Menne, Saul N. Faust, Christopher P. Fox, Matthew Ahearne, Peter W.M. Johnson, Andrew J. Davies, David Goldblatt

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