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. 2022 Dec 2:12:897937.
doi: 10.3389/fonc.2022.897937. eCollection 2022.

Immunogenicity of SARS-CoV-2 vaccination in patients undergoing autologous stem cell transplantation. A multicentric experience

Francesco Autore  1 , Luca Stirparo  2 , Idanna Innocenti  1 , Elena Papa  3 , Francesco Marchesi  3 , Chiara Togni  4 , Sabrina Mariani  4 , Lorenzo Torrieri  5 , Martina Salvatori  5 , Francesca Fazio  5 , Elisabetta Metafuni  1 , Sabrina Giammarco  1 , Federica Sora  1   2 , Paolo Falcucci  3 , Antonella Ferrari  4 , Silvia Maria Trisolini  5 , Saveria Capria  5 , Agostino Tafuri  4 , Patrizia Chiusolo  1   2 , Simona Sica  1   2 , Luca Laurenti  1   2
Affiliations

Immunogenicity of SARS-CoV-2 vaccination in patients undergoing autologous stem cell transplantation. A multicentric experience

Francesco Autore et al. Front Oncol. .

Abstract

COVID-19 disease has a strong impact on hematological patients; those receiving autologous hematopoietic stem cell transplantation (aHSCT) represent a particularly vulnerable group, in which the effectiveness of vaccination is very variable. Chiarucci et al. showed that patients affected by non-Hodgkin lymphoma (NHL) and treated with rituximab experienced a lower rate of immunization against SARS-CoV-2 (54%), as well as significantly lower IgG antibody titers. In our multicenter retrospective observational study, we included 82 patients who underwent aHSCT, divided into two groups: 58 patients vaccinated after aHSCT (group A) and 24 vaccinated before getting transplantation (group B). In group A, 39 (67%) patients had positive serology, and the rate of positivity increased with time after aHSCT. In the subgroup of patients with NHL, the administration of rituximab predicted negative serology, particularly when administered in the 6 months before vaccination (13% response rate). Patients affected by plasma cells had a higher rate of positivity (83% overall), independently of the time to aHSCT. In group B, no patient who initially showed positive serology became negative after transplantation, so the aHSCT did not affect the response to the vaccination. Our study confirmed the role of rituximab as a negative predictor of response to SARS-CoV-2 vaccination, whereas the conditioning and transplantation procedure itself seemed to be less important.

Keywords: SARSC-CoV-2; autologous stem cell transplant (ASCT); efficacy; rituximab; vaccination.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram regarding the description of inclusion and exclusion criteria of the study.
Figure 2
Figure 2
Comparison of positive serologies between patients treated and not treated with Rituximab when vaccinated after aHSCT (group A).
Figure 3
Figure 3
Serologies from patients vaccinated before aHSCT (group B).
See this image and copyright information in PMC

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