Impaired Antibody Response Following the Second Dose of the BNT162b2 Vaccine in Patients With Myeloproliferative Neoplasms Receiving Ruxolitinib

Frontiers in Medicine

article

Daisuke Ikeda¹  Toshiki Terao¹  Daisuke Miura¹  Kentaro Narita¹  Ami Fukumoto¹  Ayumi Kuzume¹  Yuya Kamura¹  Rikako Tabata¹  Takafumi Tsushima¹  Masami Takeuchi¹  Takaaki Hosoki²  Kosei Matsue¹ 

[1] Division of Hematology/Oncology, Kameda Medical Center;Department of Hematology, Kimitsu Central Hospital

关键词: COVID-19;    antibody response;    vaccine;    MPN;    ruxolitinib;    BNT162b2;   

DOI  :  10.3389/fmed.2022.826537

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Data on the effect of ruxolitinib on antibody response to severe acute respiratory coronavirus 2 (SARS-CoV-2) vaccination in patients with myeloproliferative neoplasms (MPN) is lacking. We prospectively evaluated anti-spike-receptor binding domain antibody (anti-S Ab) levels after the second dose of the BNT162b2 (Pfizer-BioNTech) vaccine in MPN patients. A total of 74 patients with MPN and 81 healthy controls who were vaccinated were enrolled in the study. Of the MPN patients, 27% received ruxolitinib at the time of vaccination. Notably, MPN patients receiving ruxolitinib had a 30-fold lower median anti-S Ab level than those not receiving ruxolitinib ( p < 0.001). Further, the anti-S Ab levels in MPN patients not receiving ruxolitinib were significantly lower than those in healthy controls ( p < 0.001). Regarding a clinical protective titre that has been shown to correlate with preventing symptomatic infection, only 10% of the MPN patients receiving ruxolitinib had the protective value. Univariate analysis revealed that ruxolitinib, myelofibrosis, and longer time from diagnosis to vaccination had a significantly negative impact on achieving the protective value ( p = 0.001, 0.021, and 0.019, respectively). In subgroup analysis, lower numbers of CD3 + and CD4 + lymphocytes were significantly correlated with a lower probability of obtaining the protective value ( p = 0.011 and 0.001, respectively). In conclusion, our results highlight ruxolitinib-induced impaired vaccine response and the necessity of booster immunisation in MPN patients. Moreover, T-cell mediated immunity may have an important role in the SARS-CoV-2 vaccine response in patients with MPN, though further studies are warranted.

【 授权许可】

CC BY