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Rossi JF, Bonnet E, Castelli C, Velensek M, Wisniewski E, Heraud S, Boustany R, David C, Dinet J, Sicard R, Daures JP, Bonifacy M, Mousset L, Goffart E. Clinical and Serological Follow-Up of 216 Patients with Hematological Malignancies after Vaccination with Pfizer-BioNT162b2 mRNA COVID-19 in a Real-World Study. Vaccines (Basel) 2023; 11:vaccines11030493. [PMID: 36992077 DOI: 10.3390/vaccines11030493] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/13/2023] [Accepted: 02/18/2023] [Indexed: 02/23/2023] Open
Abstract
Hematological malignancies (HMs) have heterogeneous serological responses after vaccination due to disease or treatment. The aim of this real-world study was to analyze it after Pfizer-BioNT162b2 mRNA vaccination in 216 patients followed up for 1 year. The first 43 patients had an initial follow-up by a telemedicine (TM) system with no major events reported. The anti-spike IgG antibodies were checked 3–4 weeks post-first vaccination and every 3–4 months, by two standard bioassays and a rapid serological test (RST). Vaccine boosts were given when the level was <7 BAU/mL. Patients who did not seroconvert after 3–4 doses received tixagevimab/cilgavimab (TC). Fifteen results were discordant between two standard bioassays. Good agreement was observed between the standard and RST in 97 samples. After two doses, 68% were seroconverted (median = 59 BAU/mL) with a median of 162 BAU/mL and 9 BAU/mL, respectively, in untreated and treated patients (p < 0.001), particularly for patients receiving rituximab. Patients with gammaglobulin levels < 5 g/L had reduced seroconversion compared to higher levels (p = 0.019). The median levels were 228 BAU/mL post-second dose if seroconverted post-first and second, or if seroconverted only post-second dose. A total of 68% of post-second dose negative patients were post-third dose positive. A total of 16% received TC, six with non-severe symptomatic COVID-19 within 15–40 days. Personalized serological follow-up should apply particularly to patients with HMs.
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Affiliation(s)
- Jean-François Rossi
- Institut du Cancer Avignon-Provence, Sainte Catherine, 84000 Avignon, France
- Faculté de Médecine Montpellier, Université de Montpellier, 34094 Montpellier, France
| | - Emmanuel Bonnet
- Recherche Clinique Clinique Beau Soleil-Nouvelles Technologies, 34070 Montpellier, France
| | - Christel Castelli
- Recherche Clinique Clinique Beau Soleil-Nouvelles Technologies, 34070 Montpellier, France
| | - Marion Velensek
- Institut du Cancer Avignon-Provence, Sainte Catherine, 84000 Avignon, France
| | - Emma Wisniewski
- Institut du Cancer Avignon-Provence, Sainte Catherine, 84000 Avignon, France
| | - Sophie Heraud
- Institut du Cancer Avignon-Provence, Sainte Catherine, 84000 Avignon, France
| | - Rania Boustany
- Institut du Cancer Avignon-Provence, Sainte Catherine, 84000 Avignon, France
| | - Céleste David
- Institut du Cancer Avignon-Provence, Sainte Catherine, 84000 Avignon, France
| | | | - Roland Sicard
- Institut du Cancer Avignon-Provence, Sainte Catherine, 84000 Avignon, France
- Thess Corporate Inc., 34070 Montpellier, France
| | - Jean-Pierre Daures
- Recherche Clinique Clinique Beau Soleil-Nouvelles Technologies, 34070 Montpellier, France
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