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- Title
Antibody Response to the SARS-CoV-2 Vaccine and COVID-19 Vulnerability during the Omicron Pandemic in Patients with CLL: Two-Year Follow-Up of a Multicenter Study.
- Authors
Mauro, Francesca R.; Giannarelli, Diana; Galluzzo, Clementina M.; Visentin, Andrea; Frustaci, Anna M.; Sportoletti, Paolo; Vitale, Candida; Reda, Gianluigi; Gentile, Massimo; Levato, Luciano; Murru, Roberta; Armiento, Daniele; Molinari, Maria C.; Proietti, Giulia; Pepe, Sara; De Falco, Filomena; Mattiello, Veronica; Barabino, Luca; Amici, Roberta; Coscia, Marta
- Abstract
Simple Summary: We prospectively analyzed COVID-19 morbidity and severity in 200 consecutive patients with CLL. Increased COVID-19 morbidity was observed in vaccinated patients with CLL. With a median follow-up of 23.4 months, 41% of patients experienced COVID-19. Most patients, 36.5%, experienced COVID-19 during the Omicron pandemic, 26% of patients were hospitalized, and 4% died. Moreover, 10% had re-infections. In multivariate analysis of elderly patients, TP53 disrupted, heavily pre-treated, and those in early treatment with targeted agents showed increased vulnerability to COVID-19. Given the persistent risk of infection due to the continuous emergence of SARS-CoV-2 variants, our results support the importance of new vaccines and protective measures to prevent and mitigate COVID-19 in patients with CLL. High morbidity and mortality due to COVID-19 were described in the pre-vaccination era in patients with chronic lymphocytic leukemia (CLL). To evaluate COVID-19 morbidity after the SARS-CoV-2 vaccine, we carried out a prospective study in 200 CLL patients. The median age of patients was 70 years; 35% showed IgG levels ≤ 550 mg/dL, 61% unmutated IGHV, and 34% showed TP53 disruption. Most patients, 83.5%, were previously treated, including 36% with ibrutinib and 37.5% with venetoclax. The serologic response rates to the second and third dose of the vaccine were 39% and 53%, respectively. With a median follow-up of 23.4 months, 41% of patients experienced COVID-19, 36.5% during the Omicron pandemic, and 10% had subsequent COVID-19 events. Severe COVID-19 requiring hospitalization was recorded in 26% of patients, and 4% died. Significant and independent factors associated with the response to the vaccine and vulnerability to COVID-19 were age (OR: 0.93; HR: 0.97) and less than 18 months between the start of targeted agents and vaccine (OR: 0.17; HR: 0.31). TP53 mutation and ≥two prior treatments also emerged as significant and independent factors associated with an increased risk of developing COVID-19 (HR: 1.85; HR: 2.08). No statistical difference in COVID-19 morbidity was found in patients with or without antibody response to the vaccine (47.5% vs. 52.5%; p = 0.21). Given the persistent risk of infection due to the continuous emergence of SARS-CoV-2 variants, our results support the importance of new vaccines and protective measures to prevent and mitigate COVID-19 in CLL patients.
- Subjects
CHRONIC lymphocytic leukemia; COVID-19; SARS-CoV-2; GENETIC mutation; COVID-19 vaccines; PSYCHOLOGICAL vulnerability; DISEASES; SEROLOGY; CANCER patients; SEVERITY of illness index; DESCRIPTIVE statistics; RESEARCH funding; VIRAL antibodies; ODDS ratio; COVID-19 pandemic; LONGITUDINAL method; EVALUATION
- Publication
Cancers, 2023, Vol 15, Issue 11, p2993
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers15112993