Humoral Responses and Chronic GVHD Exacerbation after COVID-19 Vaccination Post Allogeneic Stem Cell Transplantation

Vaccines

Paul Schnitzler¹  Carsten Müller-Tidow²  Peter Dreger²  Maria-Luisa Schubert²  Laura Simons²  Caroline Pabst²  Stefan Schönland²  Sascha Dietrich²  Nora Liebers²  Michael Schmitt²  Ute Hegenbart²  Leandra Caille²  Maike Janssen²  Aleksandar Radujkovic²  Lixiazi He²  Thomas Luft²  Claudius Speer³  Louise Benning³ 

[1] Department of Infectious Diseases, Virology, University Hospital, 69120 Heidelberg, Germany;Department of Medicine V, University Hospital Heidelberg, 69120 Heidelberg, Germany;Department of Nephrology, University of Heidelberg, 69120 Heidelberg, Germany;

关键词: allogeneic stem cell transplantation;    COVID-19;    cGVHD;    humoral responses;    immunosuppression;   

DOI  :  10.3390/vaccines10020330

来源: DOAJ

【 摘 要 】

The COVID-19 pandemic threatens patients with a compromised immune and endothelial system, including patients who underwent allogeneic stem cell transplantation (alloSCT). Thus, there is an unmet need for optimizing vaccination management in this high-risk cohort. Here, we monitored antibodies against SARS-CoV-2 spike protein (anti-S1) in 167 vaccinated alloSCT patients. Humoral immune responses were detectable in 81% of patients after two vaccinations with either mRNA-, vector-based, or heterologous regimens. Age, B-cell counts, time interval from vaccination, and the type of vaccine determined antibody titres in patients without systemic immunosuppression (sIS). Similar to a healthy control cohort, mRNA vaccine-based regimens induced higher titres than vector-based vaccines. Patients on two or more immunosuppressants rarely developed immunity. In contrast, 62% and 45% of patients without or on only one immunosuppressant, respectively, showed a strong humoral vaccination response (titre > 100). Exacerbation of cGVHD upon vaccination was observed in 6% of all patients and in 22% of patients receiving immunosuppression for cGVHD. cGVHD exacerbation and low antibody titres were both associated with higher angiopoietin-2 (ANG2) serum levels. In conclusion, mRNA-based vaccines elicit strong humoral responses in alloSCT patients in the absence of double sIS. Biomarkers such as ANG2 might help with weighing cGVHD risk versus beneficial responses.

【 授权许可】

Unknown