In Annals of hematology ; h5-index 39.0
Prior studies of antibody response after full SARS-CoV-2 vaccination in hematological patients have confirmed lower antibody levels compared to the general population. Serological response in hematological patients varies widely according to the disease type and its status, and the treatment given and its timing with respect to vaccination. Through probabilistic machine learning graphical models, we estimated the conditional probabilities of having detectable anti-SARS-CoV-2 antibodies at 3-6 weeks after SARS-CoV-2 vaccination in a large cohort of patients with several hematological diseases (n= 1166). Most patients received mRNA-based vaccines (97%), mainly Moderna® mRNA-1273 (74%) followed by Pfizer-BioNTech® BNT162b2 (23%). The overall antibody detection rate at 3 to 6 weeks after full vaccination for the entire cohort was 79%. Variables such as type of disease, timing of anti-CD20 monoclonal antibody therapy, age, corticosteroids therapy, vaccine type, disease status, or prior infection with SARS-CoV-2 are among the most relevant conditions influencing SARS-CoV-2-IgG-reactive antibody detection. A lower probability of having detectable antibodies was observed in patients with B-cell non-Hodgkin's lymphoma treated with anti-CD20 monoclonal antibodies within 6 months before vaccination (29.32%), whereas the highest probability was observed in younger patients with chronic myeloproliferative neoplasms (99.53%). The Moderna® mRNA-1273 compound provided higher probabilities of antibody detection in all scenarios. This study depicts conditional probabilities of having detectable antibodies in the whole cohort and in specific scenarios such as B cell NHL, CLL, MM, and cMPN that may impact humoral responses. These results could be useful to focus on additional preventive and/or monitoring interventions in these highly immunosuppressed hematological patients.
Piñana José Luis, Rodríguez-Belenguer Pablo, Caballero Dolores, Martino Rodrigo, Lopez-Corral Lucia, Terol María-José, Vazquez Lourdes, Calabuig Marisa, Sanz-Linares Gabriela, Marin-Jimenez Francisca, Alonso Carmen, Montoro Juan, Ferrer Elena, Facal Ana, Pascual María-Jesús, Rodriguez-Fernandez Alicia, Olave María T, Cascales-Hernandez Almudena, Gago Beatriz, Hernández-Rivas José-Ángel, Villalon Lucia, Corona Magdalena, Roldán-Pérez Alicia, Ribes-Amoros Julia, González-Santillana Clara, Garcia-Sanz Ramon, Navarro David, Serrano-López Antonio J, Cedillo Ángel, Soria-Olivas Emilio, Sureda Anna, Solano Carlos
Allogeneic stem cell transplantation, Autologous stem cell transplantation, Bayesian Networks, CAR-T therapy, COVID-19, Chronic lymphocytic leukemia, Hematological malignancies, Immunocompromised patients, Moderna mRNA-1273, Non-Hodgkin lymphoma, Pfizer-BioNTech BNT162b2, Probabilistic graphical models, Respiratory virus, SARS-CoV-2 vaccines, mRNA vaccine