COVID-19 Vaccination Induces Strong Responses in Patients With AML, MDS

In patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS), the SARS-CoV-2 vaccine induces a strong response, according to new data presented at the American Society of Hematology’s 2021 Annual Meeting.

Clarity is lacking regarding whether protective immunity in response to SARS-CoV-2 vaccines will develop in patients with AML or MDS. To clarify this response, researchers at the H. Lee Moffitt Cancer Center in Tampa, Florida, enrolled 46 patients with AML (n = 30) or MDS (n = 16) in an observational study of vaccination with mRNA-1273 vaccine from January 12 to 25, 2021. 

The group’s mean age at vaccination was 68 years (range, 37-85 yr), and most study patients were men (59%) and White (98%). Nearly 70% had had an allogeneic stem cell transplant. Most patients in the study group (87%) were in remission at the time of vaccination, but 2 patients relapsed after vaccination.

For antibody analyses, the researchers collected blood samples from the patients before the first dose of the vaccine (Day 1), before the second dose (Day 29), and approximately 28 days after the second dose. Through a retrospective chart review, they also collected baseline characteristics, cancer diagnoses, treatments received, and disease status. 

They used the 2-step ELISA to measure immunoglobulin G responses, Fisher exact or chi-square testing to compare SARS-CoV-2 antibody positivity rates, and Kruskal-Wallis testing to examine the association between SARS-CoV-2 antibody titer and patient characteristics. Paired t-testing was used to analyze the differences in SARS-CoV-2 antibody titers from blood samples collected before the first or second dose and after the second dose of vaccine. 

The researchers found that 70% of patients were seropositive after the first dose of vaccine, and 96% were after the second dose. Most clinical and laboratory variables studied, including neutropenia and lymphopenia, did not affect the rate of seropositivity. 

According to the researchers, the considerable increase in antibody titer levels after the second dose indicated the potential utility of additional doses in poor responders to vaccination. The “mRNA-1273 SARS-CoV-2 vaccine appears to induce a strong humoral response in this population of patients with AML and MDS,” they concluded.

--Ellen Kurek

Reference:

Jain AG, Dong NC, Ball S, et al. Responses to Sars-Cov-2 vaccines in patients with myelodysplastic syndrome and acute myeloid leukemia. Paper presented at: American Society of Hematology 2021 Annual Meeting & Exposition; Atlanta, Georgia; December 11-14, 2021. https://ash.confex.com/ash/2021/webprogram/Paper151669.htm