Frequency, Clinical Characteristics and Outcome of Adults With Acute Lymphoblastic Leukemia and COVID 19 Infection in the First vs. Second Pandemic Wave in Spain

Ribera, Josep‐María; Coll, Rosa; Barba, Pere; Lopez-Lorenzo, Jose-Luis; Montesinos, Pau; Foncillas, María Ángeles; Cabrero, Mónica; Gómez‐Centurión, Ignacio; Morales, M. D.; Varela, María Rosario; Herrera, Pilar; García‐Cadenas, Irene; Calbacho, M.; Torrent, Anna; Maluquer, Clara; Calabuig, Marisa; García‐Guiñón, Antoni; Bautista, Guiomar; Llorente, Laura; Gil, Cristina; Artola, María‐Teresa; González‐Campos, José; Fernández-Moreno, A.; Bárez, Abelardo; Giménez-Pérez, T.; Bergua, Juan; Sánchez‐Sánchez, María‐José; Mateos, María-Carmen; Piñana, José-Luis

doi:10.1016/j.clml.2021.06.024

Cited by 18 publications

(18 citation statements)

References 23 publications

(50 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The coronavirus infectious disease 2019 (COVID‐19) pandemic caused by the new zoonotic coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS‐CoV‐2]) is causing a massive impact globally, including patients with hematological malignancies and recipients of hematopoietic stem cell transplantation (HSCT) whose overall mortality exceeds 25%. 1 , 2 , 3 , 4 , 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

SARS‐CoV‐2‐reactive antibody detection after SARS‐CoV‐2 vaccination in hematopoietic stem cell transplant recipients: Prospective survey from the Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group

et al. 2021

View full text Add to dashboard Cite

This is a multicenter prospective observational study that included a large cohort ( n = 397) of allogeneic (allo‐HSCT; ( n = 311) and autologous (ASCT) hematopoietic stem cell transplant ( n = 86) recipients who were monitored for antibody detection within 3–6 weeks after complete severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccination from February 1, 2021, to July 20, 2021. Most patients ( n = 387, 97.4%) received mRNA‐based vaccines. Most of the recipients (93%) were vaccinated more than 1 year after transplant. Detectable SARS‐CoV‐2‐reactive antibodies were observed in 242 (78%) of allo‐HSCT and in 73 (85%) of ASCT recipients. Multivariate analysis in allo‐HSCT recipients identified lymphopenia < 1 × 10 9 /ml (odds ratio [OR] 0.33, 95% confidence interval [95% CI] 0.16–0.69, p = .003), active graft versus host disease (GvHD; OR 0.51, 95% CI 0.27–0.98, p = .04) and vaccination within the first year of transplant (OR 0.3, 95% CI 0.15–0.9, p = .04) associated with lower antibody detection whereas. In ASCT, non‐Hodgkin's lymphoma (NHL; OR 0.09, 95% CI 0.02–0.44, p = .003) and active corticosteroid therapy (OR 0.2, 95% CI 0.02–0.87, p = .03) were associated with lower detection rate. We report an encouraging rate of SARS‐CoV‐2‐reactive antibodies detection in these severe immunocompromised patients. Lymphopenia, GvHD, the timing of vaccine, and NHL and corticosteroids therapy should be considered in allo‐HSCT and ASCT, respectively, to identify candidates for SARS‐CoV‐2 antibodies monitoring.

show abstract

Section: Introductionmentioning

confidence: 99%

SARS‐CoV‐2‐reactive antibody detection after SARS‐CoV‐2 vaccination in hematopoietic stem cell transplant recipients: Prospective survey from the Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The coronavirus infectious disease 2019 (COVID-19) pandemic caused by the new coronavirus (SARS-CoV-2) can have a dreadful impact in hematological patients, with mortality rates exceeding 25% [ 1 – 6 ]. SARS-CoV-2 vaccination is expected to reduce the severity of COVID-19 in these immunocompromised patients [ 7 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background The clinical efficacy of SARS-CoV-2 vaccines according to antibody response in immunosuppressed patients such as hematological patients has not yet been established. Patients and methods A prospective multicenter registry-based cohort study conducted from December 2020 to December 2021 by the Spanish transplant and cell therapy group was used to analyze the relationship of antibody response at 3–6 weeks after full vaccination (2 doses) with breakthrough SARS-CoV-2 infection in 1394 patients with hematological disorders. Results At a median follow-up of 165 days after complete immunization, 37 out of 1394 (2.6%) developed breakthrough SARS-CoV-2 infection at median of 77 days (range 7–195) after full vaccination. The incidence rate was 6.39 per 100 persons-year. Most patients were asymptomatic (19/37, 51.4%), whereas only 19% developed pneumonia. The mortality rate was 8%. Lack of detectable antibodies at 3–6 weeks after full vaccination was the only variable associated with breakthrough infection in multivariate logistic regression analysis (Odds Ratio 2.35, 95% confidence interval 1.2–4.6, p = 0.012). Median antibody titers were lower in cases than in non-cases [1.83 binding antibody units (BAU)/mL (range 0–4854.93) vs 730.81 BAU/mL (range 0–56,800), respectively (p = 0.007)]. We identified 250 BAU/mL as a cutoff above which incidence and severity of the infection were significantly lower. Conclusions Our study highlights the benefit of developing an antibody response in these highly immunosuppressed patients. Level of antibody titers at 3 to 6 weeks after 2-dose vaccination links with protection against both breakthrough infection and severe disease for non-Omicron SARS-CoV-2 variants.

show abstract

“…Hematological patients have proven to be the most vulnerable population to coronavirus infectious disease 2019 (COVID-19) pandemic caused by the new zoonotic coronavirus (SARS-CoV-2) in terms of delayed treatments, deferral of cell therapy procedures and more importantly suffering a relevant mortality that exceeds 25% [1][2][3][4][5][6]. Although hematological patients have been inexplicably excluded from randomized SARS-CoV-2 vaccine trials, national and scientific societies have actively recommended on SARS-CoV-2 vaccination in order to lessen the severity of COVID-19 in these immunocompromised patients [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Applicability of probabilistic graphical models for early detection of SARS-CoV-2 reactive antibodies after SARS-CoV-2 vaccination in hematological patients

et al. 2022

Self Cite

View full text Add to dashboard Cite

Prior studies of antibody response after full SARS-CoV-2 vaccination in hematological patients have confirmed lower antibody levels compared to the general population. Serological response in hematological patients varies widely according to the disease type and its status, and the treatment given and its timing with respect to vaccination. Through probabilistic machine learning graphical models, we estimated the conditional probabilities of having detectable anti-SARS-CoV-2 antibodies at 3-6 weeks after SARS-CoV-2 vaccination in a large cohort of patients with several hematological diseases (n= 1166). Most patients received mRNA-based vaccines (97%), mainly Moderna® mRNA-1273 (74%) followed by Pfizer-BioNTech® BNT162b2 (23%). The overall antibody detection rate at 3 to 6 weeks after full vaccination for the entire cohort was 79%. Variables such as type of disease, timing of anti-CD20 monoclonal antibody therapy, age, corticosteroids therapy, vaccine type, disease status, or prior infection with SARS-CoV-2 are among the most relevant conditions influencing SARS-CoV-2-IgG-reactive antibody detection. A lower probability of having detectable antibodies was observed in patients with B-cell non-Hodgkin's lymphoma treated with anti-CD20 monoclonal antibodies within 6 months before vaccination (29.32%), whereas the highest probability was observed in younger patients with chronic myeloproliferative neoplasms (99.53%). The Moderna® mRNA-1273 compound provided higher probabilities of antibody detection in all scenarios. This study depicts conditional probabilities of having detectable antibodies in the whole cohort and in specific scenarios such as B cell NHL, CLL, MM, and cMPN that may impact humoral responses. These results could be useful to focus on additional preventive and/or monitoring interventions in these highly immunosuppressed hematological patients.

show abstract

Frequency, Clinical Characteristics and Outcome of Adults With Acute Lymphoblastic Leukemia and COVID 19 Infection in the First vs. Second Pandemic Wave in Spain

Cited by 18 publications

References 23 publications

SARS‐CoV‐2‐reactive antibody detection after SARS‐CoV‐2 vaccination in hematopoietic stem cell transplant recipients: Prospective survey from the Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group

SARS‐CoV‐2‐reactive antibody detection after SARS‐CoV‐2 vaccination in hematopoietic stem cell transplant recipients: Prospective survey from the Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group

SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders

Applicability of probabilistic graphical models for early detection of SARS-CoV-2 reactive antibodies after SARS-CoV-2 vaccination in hematological patients

Contact Info

Product

Resources

About