In chronic lymphocytic leukaemia (CLL) the efficacy of SARS-CoV-2 vaccination remains unclear as most studies have focused on humoral responses. Here we comprehensively examined humoral and cellular responses to vaccine in CLL patients. Seroconversion was observed in 55.2% of CLL with lower rate and antibody titres in treated patients. T-cell responses were detected in a significant fraction of patients. CD4(+) and CD8(+) frequencies were significantly increased independent of serology with higher levels of CD4(+) cells in patients under a Bruton tyrosine kinase (BTK) or a B-cell lymphoma 2 (BCL-2) inhibitor. Vaccination skewed CD8(+) cells towards a highly cytotoxic phenotype, more pronounced in seroconverted patients. A high proportion of patients showed spike-specific CD4(+) and CD8(+) cells producing interferon gamma (IFN gamma) and tumour necrosis factor alpha (TNF alpha). Patients under a BTK inhibitor showed increased production of IFN gamma and TNF alpha by CD4(+) cells. Vaccination induced a Th1 polarization reverting the Th2 CLL T-cell profile in the majority of patients with lower IL-4 production in untreated and BTK-inhibitor-treated patients. Such robust T-cell responses may have contributed to remarkable protection against hospitalization and death in a cohort of 540 patients. Combining T-cell metrics with seroprevalence may yield a more accurate measure of population immunity in CLL, providing consequential insights for public health.

Immune correlates of protection by vaccine against SARS-CoV-2 in patients with chronic lymphocytic leukaemia

Sorcini D.;De Falco F.;Gargaro M.;Bozza S.;Guarente V.;Cardinali V.;Stella A.;Adamo F. M.;Silva Barcelos E. C.;Rompietti C.;Dorillo E.;Geraci C.;Esposito A.;Arcaleni R.;Capoccia S.;Graziani A.;Cipiciani A.;Riccardi C.;Mencacci A.;Fallarino F.;Rosati E.;Sportoletti P.
2022-01-01

Abstract

In chronic lymphocytic leukaemia (CLL) the efficacy of SARS-CoV-2 vaccination remains unclear as most studies have focused on humoral responses. Here we comprehensively examined humoral and cellular responses to vaccine in CLL patients. Seroconversion was observed in 55.2% of CLL with lower rate and antibody titres in treated patients. T-cell responses were detected in a significant fraction of patients. CD4(+) and CD8(+) frequencies were significantly increased independent of serology with higher levels of CD4(+) cells in patients under a Bruton tyrosine kinase (BTK) or a B-cell lymphoma 2 (BCL-2) inhibitor. Vaccination skewed CD8(+) cells towards a highly cytotoxic phenotype, more pronounced in seroconverted patients. A high proportion of patients showed spike-specific CD4(+) and CD8(+) cells producing interferon gamma (IFN gamma) and tumour necrosis factor alpha (TNF alpha). Patients under a BTK inhibitor showed increased production of IFN gamma and TNF alpha by CD4(+) cells. Vaccination induced a Th1 polarization reverting the Th2 CLL T-cell profile in the majority of patients with lower IL-4 production in untreated and BTK-inhibitor-treated patients. Such robust T-cell responses may have contributed to remarkable protection against hospitalization and death in a cohort of 540 patients. Combining T-cell metrics with seroprevalence may yield a more accurate measure of population immunity in CLL, providing consequential insights for public health.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11391/1538837
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