Defective T-cell response to COVID-19 vaccination in acute myeloid leukaemia and myelodysplastic syndromes

Justin Loke; Vinit Upasani; Charlotte Gaskell; Sonia Fox; Rachel Fletcher; Catherine Thomas; Louise Hopkins; Anita Kumari; Tina Tang; Emily Yafai; Rebecca Boucher; Victoria Homer; Arpad Toth; Y L Tracey Chan; Katie Randall; Tom Rider; Jenny O'Nions; Victoria Drew; Arvind Pillai; Moez Dungarwalla; Duncan Murray; Anjum Khan; Farooq Wandroo; Sally Moore; Pramila Krishnamurthy; Ya-Wen Jessica Huang; Steve Knapper; Jenny Byrne; Rui Zhao; Charles Craddock; Helen Parry; Paul Moss; Simon J Stanworth; David M Lowe

doi:10.1111/bjh.18894

Defective T-cell response to COVID-19 vaccination in acute myeloid leukaemia and myelodysplastic syndromes

Br J Haematol. 2023 Aug;202(3):498-503. doi: 10.1111/bjh.18894. Epub 2023 Jun 12.

Authors

Justin Loke^{1

2

3}, Vinit Upasani⁴, Charlotte Gaskell², Sonia Fox², Rachel Fletcher², Catherine Thomas², Louise Hopkins², Anita Kumari², Tina Tang², Emily Yafai², Rebecca Boucher², Victoria Homer², Arpad Toth⁵, Y L Tracey Chan⁶, Katie Randall⁷, Tom Rider⁸, Jenny O'Nions⁹, Victoria Drew¹⁰, Arvind Pillai¹¹, Moez Dungarwalla¹², Duncan Murray¹³, Anjum Khan¹⁴, Farooq Wandroo¹⁵, Sally Moore¹⁶, Pramila Krishnamurthy¹⁷, Ya-Wen Jessica Huang¹⁸, Steve Knapper¹⁹, Jenny Byrne²⁰, Rui Zhao²¹, Charles Craddock^{1

2}, Helen Parry^{1

22}, Paul Moss^{1

22}, Simon J Stanworth^{23

24

25}, David M Lowe^{4

26}

Affiliations

¹ Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK.
² CRUK Clinical Trials Unit, University of Birmingham, Birmingham, UK.
³ Dana Farber Cancer Institute, Boston, Massachusetts, USA.
⁴ University College London, London, UK.
⁵ Clatterbridge Cancer Hospital, Liverpool, UK.
⁶ Worcestershire Acute Hospitals, Worcester, UK.
⁷ South Warwickshire University NHS Foundation Trust, Warwick, UK.
⁸ Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
⁹ University College London Hospital, London, UK.
¹⁰ Bradford Teaching Hospital, Bradford, UK.
¹¹ Countess of Chester Hospital, Chester, UK.
¹² Milton Keynes University Hospital, Milton Keynes, UK.
¹³ University Hospitals Coventry, Coventry, UK.
¹⁴ St James Hospital, Leeds, UK.
¹⁵ Sandwell and West Birmingham Hospitals NHS Trust, West Bromwich, UK.
¹⁶ Royal United Hospital Bath NHS Foundation Trust, Bath, UK.
¹⁷ King's College Hospital, London, UK.
¹⁸ Wirral University Teaching Hospital, Wirral, UK.
¹⁹ Cardiff University School of Medicine, Cardiff, UK.
²⁰ Nottingham University Hospitals Trust, Nottingham, UK.
²¹ Torbay Hospital, Torquay, UK.
²² University of Birmingham, Birmingham, UK.
²³ Oxford University Hospitals, Oxford, UK.
²⁴ University of Oxford, Oxford, UK.
²⁵ NHS Blood and Transplant, Oxford, UK.
²⁶ Royal Free London NHS Foundation Trust, London, UK.

PMID: 37303189
DOI: 10.1111/bjh.18894

Abstract

Limited data exist on COVID-19 vaccination efficacy in patients with acute myeloid leukemia and myelodysplasia with excess blasts (AML/MDS-EB2). We report results from a prospective study, PACE (Patients with AML and COVID-19 Epidemiology). 93 patients provided samples post-vaccine 2 or 3 (PV2, PV3). Antibodies against SARS-COV-2 spike antigen were detectable in all samples. Neutralization of the omicron variant was poorer than ancestral variants but improved PV3. In contrast, adequate T-cell reactivity to SARS-COV-2 spike protein was seen in only 16/47 (34%) patients PV2 and 23/52 (44%) PV3. Using regression models, disease response (not in CR/Cri), and increasing age predicted poor T cell response.

Keywords: AML; COVID; MDS; vaccination.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antibodies, Viral
COVID-19 Vaccines
COVID-19* / prevention & control
Humans
Leukemia, Myeloid, Acute* / therapy
Myelodysplastic Syndromes* / therapy
Prospective Studies
SARS-CoV-2
T-Lymphocytes
Vaccination

Substances

spike protein, SARS-CoV-2
COVID-19 Vaccines
Antibodies, Viral

Supplementary concepts

SARS-CoV-2 variants

Associated data