Antibody responses after SARS-CoV-2 vaccination in patients with lymphoma

Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19

Résumé en anglais

Individuals with lymphoid malignancies are at risk of developing severe COVID-19 and are less likely to develop protective immune responses to SARS-CoV-2 vaccination than the general population because of disease-related or treatment-related immunosuppression. Data on vaccine responses in chronic lymphocytic leukaemia have shown antibody responses in 52–75% of individuals after the second dose.1, 2 Vaccine responses after two doses in people with other lymphoid malignancies remain undefined.
In this interim analysis of the UK PROSECO study (a multicentre, prospective, observational study assessing COVID-19 vaccine immune responses in lymphoid malignancies [NCT04858568]), we report antibody levels before vaccination and 2 weeks after the first dose or 2–4 weeks after the second dose, or both, in participants with lymphoma recruited from general hospitals in Southampton, Nottingham, Leicester, Portsmouth and Oxford, UK. Participants were given either ChAdOx1 (AstraZeneca, Oxford, UK) or BNT162b2 (Pfizer-BioNTech, Puurs, Belgium) vaccines, with two doses given 10–12 weeks apart.3, 4 IgG antibodies against SARS-CoV-2 spike (S), receptor binding domain (RBD), and nucleocapsid (N) antigens were measured using a qualified electrochemiluminescent assay (Meso Scale Discovery, Rockville, MD, USA)5 and responses were reported in binding antibody units per mL (BAU/mL), and calibrated against the WHO COVID-19 international reference serum (National Institute for Biological Standards and Control number 20/136). Anti-S IgG concentrations of 0·55 BAU/mL or lower, anti-RBD IgG concentrations of 0·73 BAU/mL or lower, and anti-N IgG concentrations of 0·64 BAU/mL or lower were below the lower limit of detection. Participants with an anti-N IgG concentration of more than 6·60 BAU/mL were considered to have had previous contact with SARS-CoV-2 and were excluded from the primary analysis. Antibody titres were compared with those in healthy volunteers recruited from the UK and Latvia who had received the vaccine as part of the government vaccine roll-out. Associations were calculated using the Mann-Whitney U test, with p values of 0·05 or lower being considered to be statistically significant.