Determinants of SARS-CoV-2 waning immunity in allogeneic hematopoietic stem cell transplant recipients.
Mathieu LeclercRabah RedjoulAnne Le BouterFlorence BeckerichChristine RobinVincent ParinetCécile PautasDehbia MenoucheSelwa BouledrouaLydia RoyLudovic CabanneYakout Nait-SidenasSlim FouratiSébastien MauryPublished in: Journal of hematology & oncology (2022)
Hematopoietic stem cell transplant (HSCT) recipients are at high-risk for severe COVID-19 and have altered immune responses to vaccination. We sought to evaluate the dynamics of immune response to BNT162b2 mRNA vaccine in HSCT recipients. We systematically proposed vaccination with BNT162b2 to HSCT recipients and gave a third vaccine dose to those showing titers of IgG(S-RBD) below 4160 AU/mL 1 month following the second dose. We then quantified anti-SARS-CoV-2 antibodies dynamics in 133 of these HSCT recipients (88 after two and 45 after three vaccine doses) 6 months after the first vaccine dose. Mean IgG(S-RBD) titer at 6 months was significantly lower than the peak value measured 1 month after a second (p < 0.001) or third (p < 0.01) vaccine dose. IgG(S-RBD) titers at 6 months were strongly correlated to peak values (p < 0.001) and a peak titer above 10,370 AU/mL predicted persistent protection at 6 months. Seventy-two percent (96/133) of patients retained protective antibody levels at 6 months. Immunosuppressive drugs and low lymphocyte counts in peripheral blood correlated with lower IgG(S-RBD) titers at 6 months. Four patients (3%) developed PCR-documented SARS-CoV-2 infection and one died.
Keyphrases
- hematopoietic stem cell
- sars cov
- peripheral blood
- ejection fraction
- end stage renal disease
- immune response
- newly diagnosed
- respiratory syndrome coronavirus
- coronavirus disease
- kidney transplantation
- prognostic factors
- bone marrow
- patient reported outcomes
- inflammatory response
- early onset
- toll like receptor
- high dose
- drug induced
- quantum dots