SARS-CoV-2 vaccination in the first year after hematopoietic cell transplant or chimeric antigen receptor T cell therapy: A prospective, multicenter, observational study
05/2024
Journal Article
Authors:
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.;
Hosszu, K.;
Sharon, E.;
Spahn, A.;
Toor, A. A.;
Waldvogel, S.;
Greenberger, L. M.;
Auletta, J. J.;
Horowitz, M. M.;
Riches, M. L.;
Perales, M. A.
Journal:
Clin Infect Dis
PMID:
38801746
URL:
https://www.ncbi.nlm.nih.gov/pubmed/38801746
Keywords:
Covid-19 SARS-CoV-2 hematopoietic cell transplant transplant vaccine
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 initiated <4 months versus 4-12 months after cellular therapy. 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 <4 months vs 4-12 months after cellular therapy. Anti-S IgG >/=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.
