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How Do Patients With CLL Respond to the First Dose of the COVID-19 Vaccine?

By: Vanessa A. Carter, BS
Posted: Monday, August 9, 2021

Meletios A. Dimopoulos, MD, of the National and Kapodistrian University of Athens, and colleagues conducted a study to determine antibody responses in patients with chronic lymphocytic leukemia (CLL) who received the vaccine against SARS–CoV-2 and published their results in Clinical and Experimental Medicine. Despite discovering less-than-optimal response rates, the researchers deemed the vaccination essential, adding that “patients with suboptimal responses should be considered to be prioritized for booster doses.”

The investigators focused on 58 patients with Waldenström’s macroglobulinemia, non-Hodgkin lymphoma, and CLL. Individuals had received the BNT162b2 mRNA or AZD1222 viral vector inoculation. Notably, participants with CLL who had symptomatic (n = 11) or asymptomatic disease (n = 10) were administered BNT162b2, but one patient with symptomatic disease received AZD1222. Serum was collected on day 1 before the first dose and on day 22—the day before the second dose of BNT162b2 or 3 weeks after the AZD1222 dose. Neutralizing antibody levels were compared with 213 controls.

A total of 44 and 14 patients received the BNT162b2 and AZD1222 vaccines, respectively; 149 and 64 controls received each vaccine. On day 1, 10.3% of patients and 9.9% of controls had neutralizing antibody titers of 30% or more. However, on day 22, individuals with disease had a lower median neutralizing antibody inhibition titer than those without disease (17% vs. 32%).

Of note, 8 patients developed titers of 30% or more on day 22, whereas 114 controls did. The number of participants who reached neutralizing antibody titers of more than 50% was even lower, with 3 patients and 50 controls achieving this level. In addition, one patient who reached a neutralizing antibody level of at least 50% had asymptomatic CLL.

Disclosure: The study authors reported no conflicts of interest.



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