COVID-19
Eva M. Martínez-Cáceres, n/a
Head of the Immunology Division
Immunology Division. Laboratori clinic Metropolitana Nord (LCMN). Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
BADALONA, Catalonia, Spain
Marc Boigues, n/a
Division of Immunology, LCMN, Germans Trias i Pujol University Hospital and Research Institute, Barcelona, Spain. Department of Cellular Biology, Physiology and Immunology, Autonomous University of Barcelona, Barcelona, Spain.
Badalona, Catalonia, Spain
Maria Huguet, n/a
Hematology Department, Institut Català d’Oncologia de Badalona, Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona. Universitat Autonòma de Barcelona, Spain.
Badalona, Catalonia, Spain
Mireia Morgades, n/a
Hematology Department, Institut Català d’Oncologia de Badalona, Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona. Universitat Autonòma de Barcelona, Spain.
Badalona, Catalonia, Spain
Eudald Felip, n/a
Medical Oncology Institut Català d’Oncologia de Badalona, Hospital Germans Trias i Pujol, Badalona, Spain
Badalona, Catalonia, Spain
Christelle Ferrà, n/a
Hematology Department, Institut Català d’Oncologia de Badalona, Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona. Universitat Autonòma de Barcelona, Spain. Universitat de Vic – Universitat Central de Catalunya, Spain.
Badalona, Catalonia, Spain
Bibiana Quirant-Sanchez, n/a
Immunology specialist
Immunology Division. Laboratori clinic Metropolitana Nord (LCMN). Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
BADALONA, Catalonia, Spain
Background
Hematopoietic stem cell transplantation (HCST) has been considered for priority vaccination. However, as patients usually remain immunosuppressed for months after HSCT, vaccine efficacy might be compromised. The characterization of the immune response of transplanted patients could help to design more efficacious vaccination programs.
Methods
SARS-CoV-2 vaccination with mRNA1273 vaccine (Moderna) was prospectively evaluated in haematological patients after HSCT and serological response was assessed after complete vaccination. In patients without specific anti-SARS-CoV-2 antibodies, we reassessed humoral and cellular response after receiving a third booster dose.
Results
Eighty-seven patients (56 auto-HSCT and 31 allo-HSCT) received the complete vaccination regimen with two doses between March and May 2021. At 2-4 months, 86% of patients presented seroconversion. Median antibody response rate was higher for the allo-HSCT group (2578 UI/mL) compared to auto-HSCT group (1675.5 UI/mL). Twelve patients presented a persistent negative serological status after vaccination. We found an association between negative serological response and low B-lymphocyte count (< 113.5 cells/uL), low IgG (< 700 mg/dL) and treatment with anti-CD20 antibodies in the last year before vaccination. 11/12 patients without seroconversion received a third dose of the vaccine after which 5/11 patients achieved seroconversion and 6/11 presented cellular response.
Conclusions
Seroconversion rate after mRNA SARS-CoV-2 vaccination in HSCT recipients is elevated although lower than in the general population ( >90%). Anti-CD20 therapy, low B-lymphocyte count and hypogammaglobulinemia are associated with no serological response after vaccination. Specific immune monitoring after SARS-CoV-2 vaccination is indicated to identify booster dose candidates.
