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Campanella A, Capasso A, Heltai S, Taccetti C, Albi E, Herishanu Y, Haggenburg S, Chatzikonstantinou T, Doubek M, Kättström M, Giannopoulos K, Simkovic M, Moreno C, Massaia M, Bumbea H, Alshemmari S, Ranghetti P, Perotta E, Martini F, Sant'Antonio E, Colia M, Combi C, Levi S, Kater AP, Hazenberg M, Nijhof IS, Hofsink Q, Demosthenous C, Kotaskova J, Zaleska J, Vrbacky F, Raya AM, Bisogno D, Tripoli IE, Popov VM, Roman V, Stavroyianni N, Karypidou M, Scarano E, Locatelli M, Frenquelli M, Scarfò L, Stamatopoulos K, Ghia P. Additional booster doses in patients with chronic lymphocytic leukemia induce humoral and cellular immune responses to SARS-CoV-2 similar to natural infection regardless ongoing treatments: A study by ERIC, the European Research Initiative on CLL. Am J Hematol 2024; 99:745-750. [PMID: 38264829 DOI: 10.1002/ajh.27218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/21/2023] [Accepted: 01/01/2024] [Indexed: 01/25/2024]
Abstract
Profound immune dysregulation and impaired response to the SARS-CoV-2 vaccine put patients with chronic lymphocytic leukemia (CLL) at risk of severe COVID-19. We compared humoral memory and T-cell responses after booster dose vaccination or breakthrough infection. (Green) Quantitative determination of anti-Spike specific antibodies. Booster doses increased seroconversion rate and antibody titers in all patient categories, ultimately generating humoral responses similar to those observed in the postinfection cohort. In detail, humoral response with overscale median antibody titers arose in >80% of patients in watch and wait, off-therapy in remission, or under treatment with venetoclax single-agent. Anti-CD20 antibodies and active treatment with BTK inhibitors (BTKi) represent limiting factors of humoral response, still memory mounted in ~40% of cases following booster doses or infection. (Blue) Evaluation of SARS-CoV-2-specific T-cell responses. Number of T-cell functional activation markers documented in each patient. The vast majority of patients, including those seronegative, developed T-cell responses, qualitatively similar between treatment groups or between vaccination alone and infection cases. These data highlight the efficacy of booster doses in eliciting T-cell immunity independently of treatment status and support the use of additional vaccination boosters to stimulate humoral immunity in patients on active CLL-directed treatments.
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Affiliation(s)
- A Campanella
- Vita Salute San Raffaele University, Milan, Italy
- IRCCS San Raffaele Hospital, Milan, Italy
| | - A Capasso
- Vita Salute San Raffaele University, Milan, Italy
- IRCCS San Raffaele Hospital, Milan, Italy
| | - S Heltai
- IRCCS San Raffaele Hospital, Milan, Italy
| | - C Taccetti
- Vita Salute San Raffaele University, Milan, Italy
- IRCCS San Raffaele Hospital, Milan, Italy
| | - E Albi
- IRCCS San Raffaele Hospital, Milan, Italy
| | - Y Herishanu
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Tel Aviv University, Tel-Aviv, Israel
| | | | | | - M Doubek
- University Hospital Brno, Brno, Czech Republic
| | - M Kättström
- Department of Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | - M Simkovic
- 4th Department of Internal Medicine - Haematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
| | - C Moreno
- Hospital de la Santa Creu I Sant Pau, Josep Carreras Leukaemia Research Institute, Barcelona, Spain
| | - M Massaia
- AO S.Croce e Carle, Cuneo, Italy
- Turin University, Turin, Italy
| | - H Bumbea
- University Emergency Hospital, Bucharest, Romania
- University of Medicine and Pharmacy, Carol Davila, Bucharest, Romania
| | - S Alshemmari
- Department of Medicine, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | | | - E Perotta
- IRCCS San Raffaele Hospital, Milan, Italy
| | - F Martini
- IRCCS San Raffaele Hospital, Milan, Italy
| | | | - M Colia
- IRCCS San Raffaele Hospital, Milan, Italy
| | - C Combi
- IRCCS San Raffaele Hospital, Milan, Italy
| | - S Levi
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - A P Kater
- Amsterdam UMC, Amsterdam, The Netherlands
| | | | - I S Nijhof
- Amsterdam UMC, Amsterdam, The Netherlands
- St Antonius Hospital, Nieuwegein, The Netherlands
| | - Q Hofsink
- Amsterdam UMC, Amsterdam, The Netherlands
| | - C Demosthenous
- Centre for Research and Technology Hellas, Thessaloniki, Greece
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - J Kotaskova
- University Hospital Brno, Brno, Czech Republic
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - J Zaleska
- Medical University of Lublin, Lublin, Poland
| | - F Vrbacky
- 4th Department of Internal Medicine - Haematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
| | - A Mora Raya
- Hospital de la Santa Creu I Sant Pau, Josep Carreras Leukaemia Research Institute, Barcelona, Spain
| | | | - I E Tripoli
- AO S.Croce e Carle, Cuneo, Italy
- Turin University, Turin, Italy
| | - V M Popov
- Colentina Clinical Hospital, Bucharest, Romania
| | - V Roman
- Center of Immunology Department, Stefan S. Nicolau Institute of Virology, Bucharest, Romania
| | - N Stavroyianni
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - M Karypidou
- Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - E Scarano
- IRCCS San Raffaele Hospital, Milan, Italy
| | - M Locatelli
- Laboratory Medicine Service, IRCCS San Raffaele Hospital, Milano, Italy
| | | | - L Scarfò
- Vita Salute San Raffaele University, Milan, Italy
- IRCCS San Raffaele Hospital, Milan, Italy
| | - K Stamatopoulos
- Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - P Ghia
- Vita Salute San Raffaele University, Milan, Italy
- IRCCS San Raffaele Hospital, Milan, Italy
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Chatzileontiadou S, Hatjiharissi E, Angelopoulou M, Asimakopoulos JV, Loutsidi NE, Chatzikonstantinou T, Zikos P, Bouchla A, Bezirgiannidou Z, Kouvata E, Frouzaki C, Chaloudis P, Sotiropoulos D, Douka V, Sirigou A, Mandala E, Psyllaki M, Papadaki HA, Marinakis T, Viniou NA, Kokkori S, Kontopidou F, Skepetari A, Vassilopoulos G, Kotsianidis I, Pappa V, Lalayanni C, Baltadakis I, Delimpassi S, Pagoni M, Papaioannou M. Thromboembolic events in patients with paroxysmal nocturnal hemoglobinuria (PNH): Real world data of a Greek nationwide multicenter retrospective study. Front Oncol 2023; 13:1128994. [PMID: 36959785 PMCID: PMC10028290 DOI: 10.3389/fonc.2023.1128994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/07/2023] [Indexed: 03/09/2023] Open
Abstract
Thrombosis is the most common and a life-threatening complication in patients with Paroxysmal Nocturnal Hemoglobinuria. One-third of patients with PNH experience at least one thromboembolic event during the course of the disease, with thrombosis being the most common cause of death in these patients. The mechanism of thrombosis in PNH is complex and continues to be of great research interest. Since the introduction of C5 complement inhibitors in the treatment of PNH, the incidence of thromboembolic events has decreased substantially. We retrospectively analyzed data concerning the thrombotic episodes of 41 patients with PNH from 14 different national hematology centers in Greece. Sixteen patients (39%) experienced at least one episode of thrombosis, including, seven (43.8%) at diagnosis, seven (43.8%) during the course of the disease and two (12.5%) patients prior to PNH diagnosis. Nearly half of these individuals (n=7, 43.8%) had multiple episodes of thrombosis during the course of their disease. The most common sites of thrombosis were intra-abdominal veins. Three out of 26 patients developed thrombosis while on eculizumab. In none of the 16 patients, the thrombotic event was fatal. Our findings, despite the small number of patients, confirmed that thrombosis continues to be a significant complication of PNH affecting more than one third of the patients.
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Affiliation(s)
- S. Chatzileontiadou
- Hematology Unit, 1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E. Hatjiharissi
- Hematology Unit, 1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M. Angelopoulou
- Department of Hematology, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - J. V. Asimakopoulos
- Department of Hematology, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - N. E. Loutsidi
- Hematology - Lymphomas Department and Bone Marrow Transplant Unit, Evangelismos General Hospital, Athens, Greece
| | - T. Chatzikonstantinou
- Department of Hematology, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - P. Zikos
- Department of Hematology, General Hospital of Patras “Aghios Andreas”, Patras, Greece
| | - A. Bouchla
- Second Department of Internal Medicine and Research Unit, Hematology Unit, University General Hospital, “Attikon”, Athens, Greece
| | - Z. Bezirgiannidou
- Department of Hematology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - E. Kouvata
- Department of Hematology, University Hospital of Larissa, Larissa, Greece
| | - C. Frouzaki
- Hematology Unit, 1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - P. Chaloudis
- Hematology Unit, 1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D. Sotiropoulos
- Department of Hematology, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - V. Douka
- Department of Hematology, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - A. Sirigou
- Department of Hematology, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - E. Mandala
- Forth Department of Medicine, Aristotle University of Thessaloniki, “Hippokration” Hospital, Thessaloniki, Greece
| | - M. Psyllaki
- Department of Hematology, University of Crete School of Medicine, University Hospital of Heraklion, Heraklion, Greece
| | - H. A. Papadaki
- Department of Hematology, University of Crete School of Medicine, University Hospital of Heraklion, Heraklion, Greece
| | - T. Marinakis
- Department of Hematology, “G. Gennimatas” General Hospital, Athens, Greece
| | - N. A. Viniou
- Hematology Unit, First Department of Internal Medicine, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - S. Kokkori
- Hematology Laboratory, University General Hospital “Attikon”, Athens, Greece
| | - F. Kontopidou
- 2nd Department of Internal Medicine, Medical School, University of Athens, Hippokration General Hospital, Athens, Greece
| | - A. Skepetari
- 2nd Department of Internal Medicine, Medical School, University of Athens, Hippokration General Hospital, Athens, Greece
| | - G. Vassilopoulos
- Department of Hematology, University Hospital of Larissa, Larissa, Greece
| | - I. Kotsianidis
- Department of Hematology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - V. Pappa
- Second Department of Internal Medicine and Research Unit, Hematology Unit, University General Hospital, “Attikon”, Athens, Greece
| | - C. Lalayanni
- Department of Hematology, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - I. Baltadakis
- Hematology - Lymphomas Department and Bone Marrow Transplant Unit, Evangelismos General Hospital, Athens, Greece
| | - S. Delimpassi
- Hematology - Lymphomas Department and Bone Marrow Transplant Unit, Evangelismos General Hospital, Athens, Greece
| | - M. Pagoni
- Hematology - Lymphomas Department and Bone Marrow Transplant Unit, Evangelismos General Hospital, Athens, Greece
| | - M. Papaioannou
- Hematology Unit, 1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
- *Correspondence: M. Papaioannou,
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