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. 2022 May 31;12(5):86.
doi: 10.1038/s41408-022-00684-8.

Effectiveness, immunogenicity, and safety of COVID-19 vaccines for individuals with hematological malignancies: a systematic review

Vanessa Piechotta #  1 , Sibylle C Mellinghoff #  2   3 , Caroline Hirsch  1 , Alice Brinkmann  1 , Claire Iannizzi  1 , Nina Kreuzberger  1 , Anne Adams  4 , Ina Monsef  1 , Jannik Stemler  2   3 , Oliver A Cornely  2   3   5 , Paul J Bröckelmann  2   6 , Nicole Skoetz  7
Affiliations

Effectiveness, immunogenicity, and safety of COVID-19 vaccines for individuals with hematological malignancies: a systematic review

Vanessa Piechotta et al. Blood Cancer J. .

Abstract

The efficacy of SARS-CoV-2 vaccination in patients with hematological malignancies (HM) appears limited due to disease and treatment-associated immune impairment. We conducted a systematic review of prospective studies published from 10/12/2021 onwards in medical databases to assess clinical efficacy parameters, humoral and cellular immunogenicity and adverse events (AE) following two doses of COVID-19 approved vaccines. In 57 eligible studies reporting 7393 patients, clinical outcomes were rarely reported and rates of SARS-CoV-2 infection (range 0-11.9%), symptomatic disease (0-2.7%), hospital admission (0-2.8%), or death (0-0.5%) were low. Seroconversion rates ranged from 38.1-99.1% across studies with the highest response rate in myeloproliferative diseases and the lowest in patients with chronic lymphocytic leukemia. Patients with B-cell depleting treatment had lower seroconversion rates as compared to other targeted treatments or chemotherapy. The vaccine-induced T-cell response was rarely and heterogeneously reported (26.5-85.9%). Similarly, AEs were rarely reported (0-50.9% ≥1 AE, 0-7.5% ≥1 serious AE). In conclusion, HM patients present impaired humoral and cellular immune response to COVID-19 vaccination with disease and treatment specific response patterns. In light of the ongoing pandemic with the easing of mitigation strategies, new approaches to avert severe infection are urgently needed for this vulnerable patient population that responds poorly to current COVID-19 vaccine regimens.

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Conflict of interest statement

VP, AB, CH, CI, AA, IM, NK, JS, PJB, and NS declare no financial conflicts of interest with regard to the present study. SCM reports grants from DZIF. OAC reports grants or contracts from Amplyx, Basilea, BMBF, Cidara, DZIF, EU-DG RTD (101037867), F2G, Gilead, Matinas, MedPace, MSD, Mundipharma, Octapharma, Pfizer, Scynexis; Consulting fees from Amplyx, Biocon, Biosys, Cidara, Da Volterra, Gilead, Matinas, MedPace, Menarini, Molecular Partners, MSG-ERC, Noxxon, Octapharma, PSI, Scynexis, Seres; Honoraria for lectures from Abbott, Al-Jazeera Pharmaceuticals, Astellas, Grupo Biotoscana/United Medical/Knight, Hikma, MedScape, MedUpdate, Merck/MSD, Mylan, Pfizer; Payment for expert testimony from Cidara; Participation on a Data Safety Monitoring Board or Advisory Board from Actelion, Allecra, Cidara, Entasis, IQVIA, Jannsen, MedPace, Paratek, PSI, Shionogi; A patent at the German Patent and Trade Mark Office (DE 10 2021 113 007.7); Other interests from DGHO, DGI, ECMM, ISHAM, MSG-ERC, Wiley.

Figures

Fig. 1
Fig. 1. PRISMA flow diagram.
Selection process for articles included in systematic review.
Fig. 2
Fig. 2. Event and response rate for prioritized outcomes per study.
A SARS-CoV-2 infection, B symptomatic COVID-19, C hospital admission, D mortality, E seroconversion, F T-cell response, G any adverse events, H serious adverse events.
Fig. 3
Fig. 3. Evidence-gap maps.
A Humoral immunity (seroconversion), B cellular immunity (T-cell response).
See this image and copyright information in PMC

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