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 / F. Passamonti, A. Romano, M. Salvini, F. Merli, M.G.D. Porta, R. Bruna, E. Coviello, I. Romano, R. Cairoli, R. Lemoli, F. Farina, A. Venditti, A. Busca, M. Ladetto, M. Massaia, A. Pinto, L. Arcaini, A. Tafuri, F. Marchesi, N. Fracchiolla, M. Bocchia, D. Armiento, A. Candoni, M. Krampera, M. Luppi, V. Cardinali, S. Galimberti, C. Cattaneo, E.O. La Barbera, R. Mina, F. Lanza, G. Visani, P. Musto, L. Petrucci, F. Zaja, P.A. Grossi, L. Bertu, L. Pagano, P. Corradini, E. Derenzini, M. Marchetti, A.M. Scattolin, A. Corso, P. Tosi, F. Gherlinzoni, C.G. Passerini, M. Cavo, C. Fava, M. Turrini, C. Visco, P. Zappasodi, M. Merli, B. Mora, A.M. Vannucchi. - In: BRITISH JOURNAL OF HAEMATOLOGY. - ISSN 0007-1048. - 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

N. Fracchiolla;P. Corradini;E. Derenzini;
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.
Covid-19; leukemia; lymphoma; myeloma; SARS-CoV-2
Settore MED/15 - Malattie del Sangue
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/877509
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