Article Dans Une Revue Blood Advances Année : 2022

Humoral response to mRNA anti–COVID-19 vaccines BNT162b2 and mRNA-1273 in patients with chronic lymphocytic leukemia

1 LBAI - Lymphocytes B, Autoimmunité et Immunothérapies
2 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
3 SIMHEL - Signalisation, Microenvironnement et Hémopathies Lymphoïdes B
4 Hôpital Avicenne [AP-HP]
5 CRESS (U1153 / UMR_A 1125) - Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques
6 AP-HP - Hopital Saint-Louis [AP-HP]
7 Laboratoire d'excellence Inflamex [site Bichat]
8 Centre Hospitalier de Saint-Denis [Ile-de-France]
9 CHU Reims - Hôpital universitaire Robert Debré [Reims]
10 URCA - Université de Reims Champagne-Ardenne
11 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
12 CHU Pitié-Salpêtrière [AP-HP]
13 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
14 CIC 1402 - CIC de Poitiers – Centre d'investigation clinique de Poitiers (CIC 1402)
15 CHV - Centre Hospitalier de Versailles André Mignot
16 CRCI2NA - Centre de Recherche en Cancérologie et Immunologie Intégrée Nantes-Angers
17 CHU Angers - Centre Hospitalier Universitaire d'Angers
18 CH Argenteuil - Centre hospitalier Victor Dupouy [Centre hospitalier d'Argenteuil]
19 CHELTER - Role of intra-Clonal Heterogeneity and Leukemic environment in ThErapy Resistance of chronic leukemias
20 Centre Hospitalier Le Mans (CH Le Mans)
21 CH E.Muller Mulhouse - Centre Hospitalier Emile Muller [Mulhouse]
22 Hôpital Cochin [AP-HP]
23 Association SILLC - Soutien Information Leucémie Lymphoïde Chronique et maladie de Waldenström [Association]
24 CHU Sud Saint Pierre [Ile de la Réunion]
25 CHU Caen Normandie - CHU Caen Normandie – Centre Hospitalier Universitaire de Caen Normandie
26 Centre Léon Bérard [Lyon]
Ségolène Brichler
Damien Roos-Weil
Lise Willems

Résumé

Immunocompromised individuals such as patients with chronic lymphocytic leukemia (CLL) are at risk of impaired immune responses to vaccination. The objective of our study was to evaluate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–specific antibody responses in patients with CLL after the first, second, and third doses of the BNT162b2 or mRNA-1273 vaccines and after a single dose for patients with confirmed previous COVID-19. In all, 530 patients were included in the study. Patients received 2 doses at a 4-week interval and a third dose if they were seronegative after the second dose. Response rate was 27% after dose 1 and 52% after dose 2. Post-dose 2 treatment-naïve patients had the highest response rate (72%) followed by patients previously treated by chemoimmunotherapy (60%). Among patients receiving therapy, those receiving Bruton tyrosine kinase inhibitor alone (22%) or in combination with anti-CD20 monoclonal antibodies or venetoclax (0%) had the poorer response rate whereas patients who received venetoclax monotherapy achieved a significantly higher response rate (52%). A multivariable analysis identified age older than 65 years, ongoing CLL treatment, and gamma globulin ≤6 g/L as independent predictors of the absence of seroconversion. Post-dose 2 seronegative patients had a global response rate of 35% after dose 3. This study provides an argument for the use of a third dose and for prophylactic SARS-CoV-2 neutralizing monoclonal antibodies.

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hal-04039594 , version 1 (29-08-2025)

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Cristina Bagacean, Rémi Letestu, Chadi Al-Nawakil, Ségolène Brichler, Vincent Lévy, et al.. Humoral response to mRNA anti–COVID-19 vaccines BNT162b2 and mRNA-1273 in patients with chronic lymphocytic leukemia. Blood Advances, 2022, 6 (1), pp.207-211. ⟨10.1182/bloodadvances.2021006215⟩. ⟨hal-04039594⟩
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