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Clinical Trial
. 2023 Apr;102(4):819-827.
doi: 10.1007/s00277-023-05142-4. Epub 2023 Mar 2.

Humoral response to mRNA-based COVID-19 vaccine and booster effect of a third dose in patients with mature T cell and NK-cell neoplasms

Mirei Kobayashi #  1 , Akio Mori  2 , Masahiro Onozawa #  3 , Shihori Tsukamoto  2 , Hajime Senjo  2   3 , Takashi Ishio  2 , Emi Yokoyama  2 , Minoru Kanaya  2 , Koh Izumiyama  2 , Makoto Saito  2 , Haruna Muraki  4   5 , Masanobu Morioka  2 , Takanori Teshima  3 , Takeshi Kondo  2
Affiliations
Free PMC article
Clinical Trial

Humoral response to mRNA-based COVID-19 vaccine and booster effect of a third dose in patients with mature T cell and NK-cell neoplasms

Mirei Kobayashi et al. Ann Hematol. 2023 Apr.
Free PMC article

Abstract

Patients with lymphoid malignancies have impaired humoral immunity caused by the disease itself and its treatment, placing them at risk for severe coronavirus disease-19 (COVID-19) and reduced response to vaccination. However, data for COVID-19 vaccine responses in patients with mature T cell and NK-cell neoplasms are very limited. In this study of 19 patients with mature T/NK-cell neoplasms, anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spike antibodies were measured at 3 months, 6 months, and 9 months after the second mRNA-based vaccination. At the time of the second and third vaccinations, 31.6% and 15.4% of the patients were receiving active treatment. All patients received the primary vaccine dose and the third vaccination rate was 68.4%. In patients with mature T/NK-cell neoplasms, both seroconversion rate (p < 0.01) and antibody titers (p < 0.01) after the second vaccination were significantly lower than those in healthy controls (HC). In individuals who received the booster dose, patients had significantly lower antibody titers than those in HC (p < 0.01); however, the seroconversion rate in patients was 100%, which was the same as that in HC. The booster vaccine resulted in a significant increase of antibodies in elderly patients who had shown a response that was inferior to that in younger patients after two doses of vaccination. Since higher antibody titers and higher seroconversion rate reduced the incidence of infection and mortality, vaccination more than three times may have the advantage for patients with mature T/NK-cell neoplasms, especially in elderly patients. Clinical trial registration number: UMIN 000,045,267 (August 26th, 2021), 000,048,764 (August 26th, 2022).

Keywords: Booster vaccine effect; COVID-19; Mature T cell and NK-cell neoplasms; SARS-CoV-2; Vaccine.

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
(A) Anti-SARS-CoV-2 S antibody titers at 3 months after the second vaccination in healthy controls and in patients with mature T/NK-cell neoplasms. (B) Anti-SARS-CoV-2 S antibody titers at 9 months after the second vaccination in healthy controls and patients with mature T/NK-cell neoplasms who received the booster vaccine or those who did not receive the booster vaccine. The Mann–Whitney U test was used to compare medians of antibody titers. The two short lines show interquartile range (IQR) and the center long line shows the median. HC, healthy controls
Fig. 2
Fig. 2
Anti-SARS-CoV-2 S antibody titers after the initial vaccination and booster vaccination in healthy controls and patients with mature T/NK-cell neoplasms. Individuals who did not receive a third dose were excluded from this analysis. The Wilcoxon signed-rank test was used to compare medians of antibody titers in paired individuals. The two short lines show interquartile range (IQR) and the center long line shows the median. HC, healthy controls. M, months
Fig. 3
Fig. 3
Anti-SARS-CoV-2 S antibody titers at 3 months and 9 months after the second vaccination in patients 75 years of age or older and in patients younger than 75 years of age. Individuals who did not receive a third dose prior to the 9-month blood sampling were excluded from the analysis of 9-month blood sampling. The Mann–Whitney U test was used to compare medians of antibody titers. The two short lines show interquartile range (IQR) and the center long line shows the median. M, months
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