Seroconversion and outcomes after initial and booster COVID‐19 vaccination in adults with hematologic malignancies

{ 'indexed': {'date-parts': [[2024, 1, 5]], 'date-time': '2024-01-05T12:59:49Z', 'timestamp': 1704459589958}, 'reference-count': 30, 'publisher': 'Wiley', 'issue': '18', 'license': [ { 'start': { 'date-parts': [[2022, 7, 11]], 'date-time': '2022-07-11T00:00:00Z', 'timestamp': 1657497600000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'http://onlinelibrary.wiley.com/termsAndConditions#vor'}], 'content-domain': {'domain': ['acsjournals.onlinelibrary.wiley.com'], 'crossmark-restriction': True}, 'published-print': {'date-parts': [[2022, 9, 15]]}, 'abstract': '<jats:sec><jats:title>Background</jats:title><jats:p>Patients with hematologic malignancies ' 'have impaired humoral immunity secondary to their malignancy and its treatment, placing them ' 'at risk of severe coronavirus disease‐19 (COVID‐19) infection and reduced response to ' 'vaccination.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The authors ' 'retrospectively analyzed serologic responses to initial and booster COVID‐19 vaccination in ' '378 patients with hematologic malignancy and subsequently tracked COVID‐19–related ' 'outcomes.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Seroconversion ' 'occurred in 181 patients (48%) after initial vaccination; patients who had active malignancy ' 'or those who were recently treated with a B‐cell–depleting monoclonal antibody had the lowest ' 'rates of seroconversion. For initial nonresponders to vaccination, seroconversion after a ' 'booster dose occurred in 48 of 85 patients (56%). The seroconversion rate after the booster ' 'was similar for patients on (53%) and off (58%) active therapy ' '(<jats:italic>p</jats:italic>\xa0=\xa0.82). Thirty‐three patients (8.8%) developed a COVID‐19 ' 'infection, and there were three COVID‐19–related deaths (0.8%). Although no significant ' 'association was observed between postvaccination seroconversion and the incidence of COVID‐19 ' 'infection, no patient with seroconversion died from COVID‐19, and no patient who received ' 'tixagevimab/cilgavimab (<jats:italic>N</jats:italic>\xa0=\xa025) was diagnosed with a ' 'COVID‐19 ' 'infection.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Booster ' 'vaccinations can promote seroconversion in a significant proportion of patients who are ' 'seronegative after the initial vaccination course regardless of the specific vaccine or ' 'on/off treatment status at the time of revaccination. Although postvaccination seroconversion ' 'may not be associated with a decrease in any (including asymptomatic) COVID‐19 infection, the ' "authors' experience suggested that effective vaccination (including a booster), supplemented " 'by passive immunization using tixagevimab/cilgavimab in case of lack of seroconversion, ' 'effectively eliminated the risk of COVID‐19 death in the otherwise high‐risk ' 'population.</jats:p></jats:sec><jats:sec><jats:title>Lay summary</jats:title><jats:p>\n' '<jats:list list-type="bullet">\n' '\n' '<jats:list-item><jats:p>Patients with hematologic malignancy, especially lymphoma, have an ' 'impaired response to coronavirus disease 2019 (COVID‐19) ' 'vaccination.</jats:p></jats:list-item>\n' '\n' '<jats:list-item><jats:p>In this single‐institution review, less than one half of the patients ' 'studied made detectable antibodies.</jats:p></jats:list-item>\n' '\n' '<jats:list-item><jats:p>For those who did not make detectable antibodies after initial ' 'vaccination, over one half (65%) were able to produce antibodies after booster ' 'vaccination.</jats:p></jats:list-item>\n' '\n' '<jats:list-item><jats:p>By the end of February 2022, 33 of the original 378 patients had a ' 'documented COVID‐19 infection.</jats:p></jats:list-item>\n' '\n' '<jats:list-item><jats:p>The only deaths from COVID‐19 were in those who had undetectable ' 'antibodies, and no patient who received prophylactic antibody therapy developed a COVID‐19 ' 'infection.</jats:p></jats:list-item>\n' '</jats:list>\n' '</jats:p></jats:sec>', 'DOI': '10.1002/cncr.34354', 'type': 'journal-article', 'created': {'date-parts': [[2022, 7, 11]], 'date-time': '2022-07-11T07:01:12Z', 'timestamp': 1657522872000}, 'page': '3319-3329', 'update-policy': 'http://dx.doi.org/10.1002/crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 24, 'title': 'Seroconversion and outcomes after initial and booster <scp>COVID</scp>‐19 vaccination in adults ' 'with hematologic malignancies', 'prefix': '10.1002', 'volume': '128', 'author': [ { 'ORCID': 'http://orcid.org/0000-0003-0102-6491', 'authenticated-orcid': False, 'given': 'Thomas A.', 'family': 'Ollila', 'sequence': 'first', 'affiliation': [ { 'name': 'Department of Medicine Alpert Medical School of Brown ' 'University Providence Rhode Island USA'}, { 'name': 'Division of Hematology‐Oncology Rhode Island Hospital ' 'Providence Rhode Island USA'}]}, { 'given': 'Rebecca H.', 'family': 'Masel', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Medicine Alpert Medical School of Brown ' 'University Providence Rhode Island USA'}]}, { 'given': 'John L.', 'family': 'Reagan', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Medicine Alpert Medical School of Brown ' 'University Providence Rhode Island USA'}, { 'name': 'Division of Hematology‐Oncology Rhode Island Hospital ' 'Providence Rhode Island USA'}]}, { 'given': 'Shaolei', 'family': 'Lu', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Medicine Alpert Medical School of Brown ' 'University Providence Rhode Island USA'}, { 'name': 'Department of Pathology and Laboratory Medicine Rhode Island ' 'Hospital Providence Rhode Island USA'}]}, { 'given': 'Ralph D.', 'family': 'Rogers', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Medicine Alpert Medical School of Brown ' 'University Providence Rhode Island USA'}, { 'name': 'Division of Infectious Disease Rhode Island Hospital Providence ' 'Rhode Island USA'}]}, { 'given': 'Kimberly J.', 'family': 'Paiva', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Pathology and Laboratory Medicine Rhode Island ' 'Hospital Providence Rhode Island USA'}]}, { 'given': 'Rashida', 'family': 'Taher', 'sequence': 'additional', 'affiliation': [ { 'name': 'Division of Hematology‐Oncology Rhode Island Hospital ' 'Providence Rhode Island USA'}]}, { 'given': 'Ella', 'family': 'Burguera‐Couce', 'sequence': 'additional', 'affiliation': [ { 'name': 'Warren Alpert Medical School of Brown University Providence ' 'Rhode Island USA'}]}, { 'ORCID': 'http://orcid.org/0000-0002-7591-2069', 'authenticated-orcid': False, 'given': 'Adam S.', 'family': 'Zayac', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Medicine Alpert Medical School of Brown ' 'University Providence Rhode Island USA'}, { 'name': 'Division of Hematology‐Oncology Rhode Island Hospital ' 'Providence Rhode Island USA'}]}, { 'given': 'Inna', 'family': 'Yakirevich', 'sequence': 'additional', 'affiliation': [ { 'name': 'Division of Hematology‐Oncology Rhode Island Hospital ' 'Providence Rhode Island USA'}]}, { 'given': 'Rabin', 'family': 'Niroula', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Medicine Alpert Medical School of Brown ' 'University Providence Rhode Island USA'}, { 'name': 'Division of Hematology‐Oncology Rhode Island Hospital ' 'Providence Rhode Island USA'}]}, { 'ORCID': 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