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Defective T-cell response to COVID-19 vaccination in acute myeloid leukaemia and myelodysplastic syndromes.

Justin LokeVinit UpasaniCharlotte GaskellSonia FoxRachel FletcherCatherine ThomasLouise HopkinsAnita KumariTina TangEmily YafaiRebecca BoucherVictoria HomerArpad TothY L Tracey ChanKatie RandallTom RiderJenny O'NionsVictoria DrewArvind PillaiMoez DungarwallaDuncan MurrayAnjum Bashir KhanFarooq A WandrooSally MoorePramila KrishnamurthyYa-Wen Jessica HuangSteve KnapperJenny ByrneRui ZhaoCharles F CraddockHelen M ParryPaul A H MossSimon J StanworthDavid M Lowe
Published in: British journal of haematology (2023)
Limited data exist on COVID-19 vaccination efficacy in patients with acute myeloid leukemia and myelodysplasia with excess blasts (AML/MDS-EB2). We report results from a prospective study, PACE (Patients with AML and COVID-19 Epidemiology). 93 patients provided samples post-vaccine 2 or 3 (PV2, PV3). Antibodies against SARS-COV-2 spike antigen were detectable in all samples. Neutralization of the omicron variant was poorer than ancestral variants but improved PV3. In contrast, adequate T-cell reactivity to SARS-COV-2 spike protein was seen in only 16/47 (34%) patients PV2 and 23/52 (44%) PV3. Using regression models, disease response (not in CR/Cri), and increasing age predicted poor T cell response.
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