COVID-19 Vaccine Immunogenicity and CLL: Case Report
Posted: Wednesday, June 23, 2021
Patients with low-risk chronic lymphocytic leukemia (CLL) may be able to generate humoral and cellular responses against the COVID-19 vaccine, according to a case report from the National Institute for Infectious Diseases in Rome. In particular, a patient with stage 0, untreated CLL received the BNT162b2 COVID-19 vaccine and exhibited immune responses similar to healthy controls, seemingly without any local or systemic adverse effects. This letter to the editor was published in the Journal of Cellular and Molecular Medicine.
“Up to date, more than 310 million doses of coronavirus vaccines have been administered around the world. Despite these large numbers, there are no data describing the immunogenicity and safety of commercially available vaccines against SARS–CoV-2 in patients with hematologic malignancies,” stated Michele Bibas, MD, and colleagues.
A 54-year-old man with a 5-year history of treatment-naive nonmetastatic CLL was featured in the case study. The patient voluntarily received the BNT162b2 COVID-19 vaccine, and subsequent humoral and cell-mediated immunologic responses were compared with age- and sex-matched healthy controls (n = 10). Peripheral blood was collected for analysis immediately before vaccination, 3 weeks after the first dose, and 2 weeks after the second dose.
Baseline levels of peripheral blood mononuclear cells indicated monoclonal B lymphocytosis, with a normal gammaglobulin value (9%) and without neutropenia. Although T-cell levels in circulating lymphocytes were low (4.2%), there was a normal ratio of CD4/CD8. According to the authors, 2 weeks after the second dose, the patient appeared to exhibit a robust increase in anti-RBD IgG and SARS–CoV-2 neutralization titers, although not to the same level as those in the controls. Further, there appeared to be an increase in spike-specific T cells and interferon production. No adverse events were reported for this patient.
The study authors concluded: “…It is imperative to generate data to define efficacy and persistence of the immune response in similar untreated patients and in those receiving immunosuppressive therapy.”
Disclosure: The study authors reported no conflicts of interest.
