SARS-CoV-2 vaccination in the first year after hematopoietic cell transplant or chimeric antigen receptor T cell therapy: A prospective, multicenter, observational study.
Publication/Presentation Date
5-27-2024
Abstract
BACKGROUND: The optimal timing of vaccination with SARS-CoV-2 vaccines after cellular therapy is incompletely understood. The objectives of this study are to determine whether humoral and cellular responses after SARS-CoV-2 vaccination differ if initiatedtherapy.
METHODS: We conducted a multicenter prospective observational study at 30 cancer centers in the United States. SARS-CoV-2 vaccination was administered as part of routine care. We obtained blood prior to and after vaccinations at up to five time points and tested for SARS-CoV-2 spike (anti-S) IgG in all participants and neutralizing antibodies for Wuhan D614G, Delta B.1.617.2, and Omicron B.1.1.529 strains, as well as SARS-CoV-2-specific T cell receptors (TCRs), in a subgroup.
RESULTS: We enrolled 466 allogeneic hematopoietic cell transplant (HCT; n=231), autologous HCT (n=170), and chimeric antigen receptor T cell (CAR-T cell) therapy (n=65) recipients between April 2021 and June 2022. Humoral and cellular responses did not significantly differ among participants initiating vaccinations≥2,500 U/mL was correlated with high neutralizing antibody titers and attained by the last time point in 70%, 69%, and 34% of allogeneic HCT, autologous HCT, and CAR-T cell recipients, respectively. SARS-CoV-2-specific T cell responses were attained in 57%, 83%, and 58%, respectively. Pre-cellular therapy SARS-CoV-2 infection or vaccination were key predictors of post-cellular therapy immunity.
CONCLUSIONS: These data support mRNA SARS-CoV-2 vaccination prior to, and reinitiation three to four months after, cellular therapies with allogeneic HCT, autologous HCT, and CAR-T cell therapy.
ISSN
1537-6591
Published In/Presented At
Hill, J. A., Martens, M. J., Young, J. H., Bhavsar, K., Kou, J., Chen, M., Lee, L. W., Baluch, A., Dhodapkar, M. V., Nakamura, R., Peyton, K., Howard, D. S., Ibrahim, U., Shahid, Z., Armistead, P., Westervelt, P., McCarty, J., McGuirk, J., Hamadani, M., DeWolf, S., … Perales, M. A. (2024). SARS-CoV-2 vaccination in the first year after hematopoietic cell transplant or chimeric antigen receptor T cell therapy: A prospective, multicenter, observational study. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, ciae291. Advance online publication. https://doi.org/10.1093/cid/ciae291
Disciplines
Medicine and Health Sciences
PubMedID
38801746
Department(s)
Hematology-Medical Oncology Division Fellows and Residents, Hematology-Medical Oncology Division
Document Type
Article