Immunogenicity of COVID-19 mRNA vaccines in patients with acute myeloid leukemia and myelodysplastic syndrome

Abstract

Immunocompromised patients are susceptible to complications from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The mRNA vaccines BNT162b2 and mRNA-1273 are effective in immunocompetent adults, but have diminished activity in immunocompromised patients. We measured anti-spike SARS-CoV-2 antibody (anti-S) response, avidity, and surrogate neutralizing antibody activity in COVID-19 vaccinated patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Anti-S was induced in 89% of AML and 88% of MDS patients, but median levels were significantly lower than in healthy controls. SARS-CoV-2 antibody avidity and neutralizing activity from AML patients were significantly lower than controls. Antibody avidity was significantly greater in patients after mRNA-1273 versus BNT162b2; there were trends toward higher anti-S levels and greater neutralizing antibody activity after mRNA-1273 vaccination. Patients with AML and MDS are likely to respond to COVID-19 mRNA vaccination, but differences in anti-S levels, avidity, and neutralizing antibody activity may affect clinical outcomes and require further study.

Keywords:

• COVID-19 vaccine immunogenicity
• myeloid leukemias and dysplasias
• infectious complications of neoplasia
• the humoral immune response

Disclosure statement

Z.Z.: Roche Diagnostics, ET Healthcare (Research Support); S.R-B.: Roche Diagnostics (Research Support); G.J.R. AbbVie, Agios, Amgen, Astellas, AstraZeneca, Bristol Myers Squibb, Blueprint Medicines, Bluebird Bio, Celgene, Glaxo SmithKline, Janssen, Jasper Therapeutics, Jazz, MEI Pharma, Mesoblast, Novartis, Pfizer, Syndax, Takeda (Consultancy or Advisory Board or Data and Safety Monitoring Committee); Janssen (Research Support); D.C.H., K.J.S., P.C., I.N., T.N., J.C., E.K.R., P.D., M.S. have no conflicts of interest or disclosures.

Additional information

Funding

Dr. Paul Christos was partially supported by the following grant: Clinical and Translational Science Center at Weill Cornell Medical College (1-UL1-TR002384-01). This work was supported by Leukemia Fighters.