Immune responses against SARS-CoV-2 variants after two and three doses of vaccine in B-cell malignancies: UK PROSECO study

Patients with hematological malignancies are at increased risk of severe COVID-19 outcomes due to compromised immune responses, but the insights of these studies have been compromised due to intrinsic limitations in study design. Here we present the PROSECO prospective observational study (NCT04858568) on 457 patients with lymphoma that received two or three COVID-19 vaccine doses. We show undetectable humoral responses following two vaccine doses in 52% of patients undergoing active anticancer treatment. Moreover, 60% of patients on anti-CD20 therapy had undetectable antibodies following full vaccination within 12 months of receiving their anticancer therapy. However, 70% of individuals with indolent B-cell lymphoma displayed improved antibody responses following booster vaccination. Notably, 63% of all patients displayed antigen-specific T-cell responses, which increased after a third dose irrespective of their cancer treatment status. Our results emphasize the urgency of careful monitoring of COVID-19-specific immune responses to guide vaccination schemes in these vulnerable populations.

Author list

 

Sean H. Lim, 

Beth Stuart, 

Debora Joseph-Pietras, 

Marina Johnson, 

Nicola Campbell, 

Adam Kelly, 

Danielle Jeffrey, 

Anna H. Turaj, 

Kate Rolfvondenbaumen, 

Celine Galloway, 

Thomas Wynn, 

Adam R. Coleman, 

Benjamin Ward, 

Karen Long, 

Helen Coleman, 

Carina Mundy, 

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 

Novel Coronavirus SARS-CoV-2

10.1038/s43018-022-00364-3

Nature - Cancer