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Antibody Response to COVID-19 Vaccine in Patients With CLL

By: Joseph Fanelli
Posted: Wednesday, July 7, 2021

The antibody-mediated response to the BNT162b2 mRNA COVID-19 vaccine is “markedly impaired” in patients with chronic lymphocytic leukemia (CLL), according to findings presented in the journal Blood. The effectiveness of the vaccine was found to be impacted by disease activity and treatment status, according to Paolo Ghia, MD, PhD, of the Università Vita-Salute San Raffaele, Milan, Italy, and colleagues.

“In patients treated with either Bruton’s tyrosine kinase [BTK] inhibitors or venetoclax ± anti-CD20 antibody, responses are relatively low [to the vaccine],” the authors said.

In this study, the authors evaluated the humoral immune response to the BNT162b2 mRNA COVID-19 vaccine in 167 patients with CLL and compared those responses with age-matched patients without CLL. The patients received two vaccine doses 21 days apart.

The antibody response rate for patients with CLL was 39.5%. In comparison to 52 patients with CLL and 52 sex- and age-matched control patients, those with CLL had a significantly lower response rate (52% vs. 100%, respectively). Among patients with CLL, the response rate was highest among those who had reached clinical remission after treatment (79.2%), followed by those who were treatment-naive (55.2%), and finally those undergoing treatment at the time of vaccination (16%).

Response rates were lower for patients treated with either BTK inhibitors or venetoclax with or without an anti-CD20 antibody (16.0% vs. 13.6%, respectively). No patients exposed to anti-CD20 antibodies a year before vaccination were found to respond to the treatment. A multivariate analysis found that younger age, female sex, lack of active treatment, IgG levels of at least 550 mg/dL, and IgM levels of at least 40mg/dL appeared to be independent predictors of response to the vaccine.

Disclosure: The authors reported no conflicts of interest.

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