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Antibody Response in Patients With CLL Following COVID-19 Vaccination

By: Gavin Calabretta, BS
Posted: Friday, October 15, 2021

Recent findings suggest that patients with chronic lymphocytic leukemia (CLL) may be less likely to develop an adequate spike-specific antibody response following the first and second COVID-19 vaccination doses. Paul Moss, PhD, of the University of Birmingham, England, and colleagues published the results of this study in Blood Cancer Journal.

In the 299-patient study, patients with CLL or small lymphocytic leukemia were selected to give blood samples after their first and second doses of the vaccination; they were compared with age-matched healthy individuals. A total of 154 patients received the BNT162b2 vaccine, and 145 were given ChAdOx1. Both 2-week (n = 13) and 10- to 12-week (n = 286) dose intervals were applied.

For the first-dose analysis, 86 venipuncture serum samples were taken simultaneously with 82 dried blood samples. Separately, 185 other dried blood samples were obtained for a total of 267 results. A total of 34% of serum samples (n = 86) and 24% of dried blood samples (n = 267) exhibited a positive antibody response, compared with 94% (n = 95) and 71% (n = 93) in healthy donors, respectively.

For the-second dose analysis, 75% (n = 12) of patient serum samples and 71% (n = 55) of dried blood samples were positive. These percentages were 100% (n = 59) and 97% (n = 37) in healthy individuals, respectively. It is important to note that antibody titers were much lower in the patient group. Additionally, Bruton’s tyrosine kinase inhibitor treatments, as well as immunoglobin A deficiency, were linked to poor antibody response, and previous infection was linked to increased response.

“Immune responses elicited after the first and second vaccine are substantially reduced in patients with chronic lymphocytic leukemia. These findings raise a number of questions in relation to optimization of vaccine protection in this vulnerable cohort,” the authors concluded. “One option might be to consider a third ‘booster vaccine,’” they added.

Disclosure: The study authors reported no conflicts of interest.

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