What Response to the COVID-19 Vaccine Can Be Expected in Patients After Stem Cell Transplantation?

27. 4. 2022

During the recent virtual congress of the European Society for Blood and Marrow Transplantation (EBMT 2022), a study by Saudi experts was presented that explored the response to vaccination against SARS-CoV-2, the causative agent of COVID-19, in patients who had undergone stem cell transplantation (SCT).

Study Design and Methodology

The authors focused on the antibody production against SARS-CoV-2 following vaccination in patients after autologous or allogeneic SCT. In the presented cross-sectional study, they worked with a set of 51 patients who had undergone SCT (23 with autologous SCT and 28 with allogeneic SCT) and were vaccinated with vaccines from Pfizer/BioNTech or AstraZeneca. Participant recruitment took place from May 1 to November 30, 2021. The researchers collected blood samples and tested them for the presence of IgG antibodies against the spike protein of the SARS-CoV-2 virus using the ELISA method.

Results

Approximately 60% of patients after SCT had a humoral protective immunity against SARS-CoV-2 after the first vaccine dose. This immune response dramatically increased after the second dose regardless of the vaccine type. No significant differences in immune response were observed between patients with autologous or allogeneic SCT. The researchers found that similar responses were achieved in patients with malignant and non-malignant diseases. Most individuals who had previously undergone SCT showed a good immune response after the second vaccine dose, except for one patient who had poor T lymphocyte engraftment despite adhering to immunosuppressive medication, and another currently undergoing B lymphocyte ablation.

Concerns about immune protection were not confirmed even in patients receiving medication for graft-versus-host disease (GvHD) prophylaxis, specifically cyclosporine, tacrolimus, sirolimus, or ruxolitinib, or in patients receiving targeted therapy, specifically nivolumab, bortezomib, ixazomib.

Conclusion

Patients after SCT had a good response to SARS-CoV-2 vaccination in this study. This response increased with the subsequent vaccine dose regardless of the original diagnosis. “Our results provide evidence that vaccination against SARS-CoV-2 generates protective immunity in this high-risk population, even in patients taking some immunosuppressive medication,” the authors conclude.

(esr)

Source: Alroqi F., Alahmari B., Alzahrani M. et al. COVID19 vaccine responses in patients post stem cell transplant. Poster. EBMT, 2022.

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Paediatric clinical oncology Haematology Clinical oncology

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