COVID-19 is associated with high mortality in patients with haematological malignancies (HM) and rate of seroconversion is unknown. The ITA-HEMA-COV project (NCT04352556) investigated patterns of seroconversion for SARS-CoV-2 IgG in patients with HMs. A total of 237 patients, SARS-CoV-2 PCR-positive with at least one SARS-CoV-2 IgG test performed during their care, entered the analysis. Among these, 62 (26·2%) had myeloid, 121 (51·1%) lymphoid and 54 (22·8%) plasma cell neoplasms. Overall, 69% of patients (164 of 237) had detectable IgG SARS-CoV-2 serum antibodies. Serologically negative patients (31%, 73 of 237) were evenly distributed across patients with myeloid, lymphoid and plasma cell neoplasms. In the multivariable logistic regression, chemoimmunotherapy [odds ratio (OR), 3·42; 95% confidence interval (CI), 1·04–11·21; P = 0·04] was associated with a lower rate of seroconversion. This effect did not decline after 180 days from treatment withdrawal (OR, 0·35; 95% CI: 0·11–1·13; P = 0·08). This study demonstrates a low rate of seroconversion in HM patients and indicates that treatment-mediated immune dysfunction is the main driver. As a consequence, we expect a low rate of seroconversion after vaccination and thus we suggest testing the efficacy of seroconversion in HM patients.
COVID-19 elicits an impaired antibody response against SARS-CoV-2 in patients with haematological malignancies / Passamonti F.; Romano A.; Salvini M.; Merli F.; Porta M.G.D.; Bruna R.; Coviello E.; Romano I.; Cairoli R.; Lemoli R.; Farina F.; Venditti A.; Busca A.; Ladetto M.; Massaia M.; Pinto A.; Arcaini L.; Tafuri A.; Marchesi F.; Fracchiolla N.; Bocchia M.; Armiento D.; Candoni A.; Krampera M.; Luppi M.; Cardinali V.; Galimberti S.; Cattaneo C.; La Barbera E.O.; Mina R.; Lanza F.; Visani G.; Musto P.; Petrucci L.; Zaja F.; Grossi P.A.; Bertu L.; Pagano L.; Corradini P.; Derenzini E.; Marchetti M.; Scattolin A.M.; Corso A.; Tosi P.; Gherlinzoni F.; Passerini C.G.; Cavo M.; Fava C.; Turrini M.; Visco C.; Zappasodi P.; Merli M.; Mora B.; Vannucchi A.M.. - In: BRITISH JOURNAL OF HAEMATOLOGY. - ISSN 0007-1048. - STAMPA. - 195:3(2021), pp. 371-377. [10.1111/bjh.17704]
COVID-19 elicits an impaired antibody response against SARS-CoV-2 in patients with haematological malignancies
Lanza F.;Cavo M.;
2021
Abstract
COVID-19 is associated with high mortality in patients with haematological malignancies (HM) and rate of seroconversion is unknown. The ITA-HEMA-COV project (NCT04352556) investigated patterns of seroconversion for SARS-CoV-2 IgG in patients with HMs. A total of 237 patients, SARS-CoV-2 PCR-positive with at least one SARS-CoV-2 IgG test performed during their care, entered the analysis. Among these, 62 (26·2%) had myeloid, 121 (51·1%) lymphoid and 54 (22·8%) plasma cell neoplasms. Overall, 69% of patients (164 of 237) had detectable IgG SARS-CoV-2 serum antibodies. Serologically negative patients (31%, 73 of 237) were evenly distributed across patients with myeloid, lymphoid and plasma cell neoplasms. In the multivariable logistic regression, chemoimmunotherapy [odds ratio (OR), 3·42; 95% confidence interval (CI), 1·04–11·21; P = 0·04] was associated with a lower rate of seroconversion. This effect did not decline after 180 days from treatment withdrawal (OR, 0·35; 95% CI: 0·11–1·13; P = 0·08). This study demonstrates a low rate of seroconversion in HM patients and indicates that treatment-mediated immune dysfunction is the main driver. As a consequence, we expect a low rate of seroconversion after vaccination and thus we suggest testing the efficacy of seroconversion in HM patients.| File | Dimensione | Formato | |
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