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

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• dc.contributor.author Piñana, José Luis
• dc.contributor.author Rodríguez-Belenguer, Pablo
• dc.contributor.author Navarro, David
• dc.contributor.author Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH-TC)
• dc.date.accessioned 2022-11-18T07:28:54Z
• dc.date.available 2022-11-18T07:28:54Z
• dc.date.issued 2022
• dc.description.abstract 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.
• dc.format.mimetype application/pdf
• dc.identifier.citation Piñana JL, López-Corral L, Martino R, Vazquez L, Pérez A, Martin-Martin G, Gago B, et al. SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders. SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders. J Hematol Oncol. 2022 May 7; 15(1): 54. DOI: 10.1186/s13045-022-01275-7
• dc.identifier.doi http://dx.doi.org/10.1186/s13045-022-01275-7
• dc.identifier.issn 1756-8722
• dc.identifier.uri http://hdl.handle.net/10230/54914
• dc.language.iso eng
• dc.publisher BioMed Central
• dc.rights Copyright © Piñana JL, López-Corral L, Martino R, Vazquez L, Pérez A, Martin-Martin G, Gago B, et al. 2022. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Allogeneic stem cell transplantation
• dc.subject.keyword Autologous stem cell transplantation
• dc.subject.keyword Breakthrough SARS-CoV-2 infection
• dc.subject.keyword COVID-19
• dc.subject.keyword Correlates of protection
• dc.subject.keyword Hematological malignancies
• dc.subject.keyword Immunocompromised patients
• dc.subject.keyword Moderna mRNA-1273
• dc.subject.keyword Pfizer-BioNTech BNT162b2
• dc.subject.keyword SARS-CoV-2 vaccines
• dc.subject.keyword Vaccine
• dc.title SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion