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Pascale SP, Nuccorini R, Pierri T, Di Mare R, Fabio L, Lerose E, Merlino MA, Schiavo P, Amendola A, Brucoli G, Caputo MD, Chitarrelli I, Cimminiello M, Coluzzi S, Filardi NB, Matturro A, Vertone D, Poggiaspalla M, Malaspina F, Musuraca G, Coralluzzo G, Mannarella C, Musto C, Bellettieri AP, Martinelli G, Cerchione C, Pizzuti M. Evaluation of serological response to anti-SARS-CoV-2 mRNA vaccination in hematological patients. Front Immunol 2022; 13:892331. [PMID: 36003404 PMCID: PMC9393554 DOI: 10.3389/fimmu.2022.892331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/07/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction In immunocompromised patients, SARS-CoV-2 mRNA vaccine has been used in Italy from the beginning of the vaccination campaign, but several studies have shown that the serological response of onco-hematological patients was reduced compared to healthy subjects, due to the state of immunosuppression because of both underlying disease and administered therapy. Methods We evaluated the association of anti-SARS-CoV-2 spike IgG titers in 215 hematological patients with clinical and demographic variables to verify if it was possible to identify predictive parameters of serological response, as well as using a control group, consisting of healthy health workers of San Carlo Hospital in Potenza. Anti-SARS-CoV2 IgG titers were evaluated after 30–45 days post second dose vaccine using chemiluminescent microparticle immunoassay technology. Results Patients with hematological malignancies, compared with the control arm, had both a mean concentration of anti-SARS-CoV-2 IgG significantly lower and a seroconversion rate numerically lower. All chronic lymphatic leukemia patients showed levels of antibody titer below the mean concentration, also in only clinical surveillance patients. Comparing serological response in hematological malignancies, only acute leukemia patients who were off therapy had the highest seroconversion rate among the patients’ cohorts and a mean antibody concentration greater than the control arm. Patients treated with steroids and rituximab showed a lower level of anti-SARS-CoV-2 spike IgG. Differences in anti-spike IgG levels among chronic myeloid leukemia patients stratified according to tyrosine kinase inhibitor therapy and molecular response were observed, and they could have interesting implications on the evaluation of the effects of these drugs on the immune system, but having not reached statistical significance at the moment. The cohort of patients who received a stem cell transplant was very heterogeneous because it included different hematological malignancies and different types of transplant; however, a mean concentration of anti-SARS-CoV2 IgG greater than the control arm was reported. Indeed, among patients who performed a transplant for over 6 months only one had a spike IgG concentration below the cutoff. Conclusions Our data confirm reduced serological response in hematological patients after anti-SARS-CoV-2 vaccination. However, we found a great diversity of SARS-CoV-2 antibody response according to types of pathologies and therapies.
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Affiliation(s)
| | - Roberta Nuccorini
- UOC di Ematologia, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | - Teresa Pierri
- UO di Medicina Trasfusionale, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | - Roberta Di Mare
- UOC di Ematologia, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | - Lucia Fabio
- UOC di Ematologia, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | - Emilia Lerose
- UOC di Ematologia, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | | | - Pietro Schiavo
- UOC di Ematologia, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | - Angela Amendola
- UOC di Ematologia, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | - Gino Brucoli
- UO di Medicina Trasfusionale, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | - Maria Denise Caputo
- UOC di Ematologia, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | - Ida Chitarrelli
- UOC di Ematologia, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | - Michele Cimminiello
- UOC di Ematologia, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | - Sabrina Coluzzi
- UOC di Ematologia, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | | | - Angela Matturro
- UOC di Ematologia, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | - Domenico Vertone
- UOC di Ematologia, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | - Monica Poggiaspalla
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Francesco Malaspina
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Gerardo Musuraca
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Gennaro Coralluzzo
- UOC di Ematologia, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | - Clara Mannarella
- UOS di Ematologia, Presidio Ospedaliero “Madonna delle Grazie”, Matera, Italy
| | - Clelia Musto
- UO di Medicina Trasfusionale, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
| | | | - Giovanni Martinelli
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Claudio Cerchione
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
- *Correspondence: Claudio Cerchione, ; Michele Pizzuti,
| | - Michele Pizzuti
- UOC di Ematologia, Azienda Ospedaliera Regionale “San Carlo”, Potenza, Italy
- *Correspondence: Claudio Cerchione, ; Michele Pizzuti,
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