Immunogenicity of COVID-19 vaccines in patients with follicular lymphoma receiving frontline chemoimmunotherapy.


Lim, Yeong Jer ORCID: 0000-0002-9022-2904, Ward, Victoria, Brown, Anthony, Phillips, Eloise, Kronsteiner, Barbara, Malone, Tom, Jennings, Daisy, Healy, Saoirse, Longet, Stephanie, James, Timothy et al (show 20 more authors) (2024) Immunogenicity of COVID-19 vaccines in patients with follicular lymphoma receiving frontline chemoimmunotherapy. British journal of haematology, 205 (2). pp. 440-451. ISSN 0007-1048, 1365-2141

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Abstract

Immune responses to primary COVID-19 vaccination were investigated in 58 patients with follicular lymphoma (FL) as part of the PETReA trial of frontline therapy (EudraCT 2016-004010-10). COVID-19 vaccines (BNT162b2 or ChAdOx1) were administered before, during or after cytoreductive treatment comprising rituximab (depletes B cells) and either bendamustine (depletes CD4<sup>+</sup> T cells) or cyclophosphamide-based chemotherapy. Blood samples obtained after vaccine doses 1 and 2 (V1, V2) were analysed for antibodies and T cells reactive to the SARS-CoV-2 spike protein using the Abbott Architect and interferon-gamma ELISpot assays respectively. Compared to 149 healthy controls, patients with FL exhibited lower antibody but preserved T-cell responses. Within the FL cohort, multivariable analysis identified low pre-treatment serum IgA levels and V2 administration during induction or maintenance treatment as independent determinants of lower antibody and higher T-cell responses, and bendamustine and high/intermediate FLIPI-2 score as additional determinants of a lower antibody response. Several clinical scenarios were identified where dichotomous immune responses were estimated with >95% confidence based on combinations of predictive variables. In conclusion, the immunogenicity of COVID-19 vaccines in FL patients is influenced by multiple disease- and treatment-related factors, among which B-cell depletion showed differential effects on antibody and T-cell responses.

Item Type: Article
Uncontrolled Keywords: Humans, Lymphoma, Follicular, Cyclophosphamide, Antineoplastic Combined Chemotherapy Protocols, Antibodies, Viral, Immunotherapy, Adult, Aged, Middle Aged, Female, Male, Spike Glycoprotein, Coronavirus, Bendamustine Hydrochloride, Rituximab, Immunogenicity, Vaccine, COVID-19, COVID-19 Vaccines, BNT162 Vaccine
Depositing User: Symplectic Admin
Date Deposited: 12 Aug 2024 14:27
Last Modified: 08 Feb 2025 04:00
DOI: 10.1111/bjh.19562
Open Access URL: https://doi.org/10.1111/bjh.19562
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3183567
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