Evaluation of Antibody Responses in Patients with B-Cell Malignancies after Two and Three Doses of Anti-SARS-CoV-2 S Vaccination-A Retrospective Cohort Study

Stella Rosa Maria Wirth; Klaus Podar; Martin Pecherstorfer; Philipp Wohlfarth; Ulrich Jaeger; Josef Singer

doi:10.3390/cancers15020524

Evaluation of Antibody Responses in Patients with B-Cell Malignancies after Two and Three Doses of Anti-SARS-CoV-2 S Vaccination-A Retrospective Cohort Study

Cancers (Basel). 2023 Jan 14;15(2):524. doi: 10.3390/cancers15020524.

Authors

Stella Rosa Maria Wirth¹, Klaus Podar^{1

2

3}, Martin Pecherstorfer^{1

3}, Philipp Wohlfarth⁴, Ulrich Jaeger⁵, Josef Singer^{1

3}

Affiliations

¹ Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria.
² Division of Molecular Oncology and Hematology, Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria.
³ Department of Internal Medicine II, University Hospital Krems, Mitterweg 10, 3500 Krems, Austria.
⁴ Department of Internal Medicine I, Hematopoietic Stem Cell Transplantation Unit, Medical University of Vienna, 1090 Vienna, Austria.
⁵ Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, 1090 Vienna, Austria.

Abstract

Patients with B-cell malignancies are at a higher risk of severe SARS-CoV-2 infections. Nevertheless, extensive data on the immune responses of hematological patients and the efficacy of the third dose of the vaccine are scarce. The goal of this study was to determine standardized anti-SARS-CoV-2 S antibody levels and to evaluate differences between treatment modalities in response to the second and third vaccines among patients with B-cell malignancies treated at the University Hospital Krems and the University Hospital of Vienna. The antibody levels of a total of 80 patients were retrospectively analyzed. The results indicate a significant increase in antibody production in response to the third vaccination. The highest increases could be observed in patients in a "watchful-waiting" and "off-therapy" setting. Encouragingly, approximately one-third of patients who did not develop antibodies in response to two vaccinations achieved seroconversion after the third vaccination. "Watchful-waiting", "off-therapy" and treatment with BTK inhibitors were indicative for increased antibody response after the third dose compared to anti-CD19 CAR T-cell and anti-CD-20 antibody treatment. In summary, the results of this study underline the pre-eminent role of the need for complete vaccination with three doses for the development of protective immunity in patients with B-cell malignancies.

Keywords: B-cell malignancies; COVID-19; SARS-CoV-2; SARS-CoV-2 S vaccine; antibody response; seroconversion; third vaccination.

Grants and funding

The authors appreciate the contribution of NÖ Landesgesundheitsagentur, the legal entity of University Hospitals in Lower Austria, for providing the organizational framework to conduct this research. They would also like to acknowledge the support by the Open Access Publishing Fund of Karl Landsteiner University of Health Sciences, Krems, Austria. KP is the recipient of the Technopol grant WST3-F-5031298/002-2018 (KP) and the WST3-F-5031 298/003-2019 as well as of a research support grant from Roche Pharmaceuticals. U.J. received funding from the Innovative Medicines Initiative Joint Undertaking, under grant agreement no. 116026 (T2EVOLVE). This Joint Undertaking received support from the European Union’s Horizon 2020 Research and Innovation Program and EFPIA.