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. 2022;67(2):91-95.
doi: 10.1159/000521229. Epub 2021 Dec 6.

Efficacy of the BNT162b2 mRNA COVID-19 Vaccine in Patients with Chronic Lymphocytic Leukemia: A Serologic and Cellular Study

Stefano Molica  1 , Diana Giannarelli  2 , Mirella Lentini  1 , Daniela Zappala  1 , Ada Mannella  1 , Daniela Loiacono  1 , Valentina Gianfelici  1 , Giuseppina Panduri  3 , Iris Gariani  1 , Pasquale Minchella  3 , Francesco Talarico  1 , Luciano Levato  1
Affiliations

Efficacy of the BNT162b2 mRNA COVID-19 Vaccine in Patients with Chronic Lymphocytic Leukemia: A Serologic and Cellular Study

Stefano Molica et al. Chemotherapy. 2022.

Abstract

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.

Keywords: Chronic lymphocytic leukemia; Serologic response; Severe acute respiratory syndrome coronavirus 2 mRNA vaccination; T-cell assessment.

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Conflict of interest statement

The authors do not have anything to disclose.

Figures

Fig. 1
Fig. 1
Anti-SARS-CoV-2 antibody levels in patients with CLL according to disease status. Results are expressed as log value.
See this image and copyright information in PMC

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