Safety and efficacy of the BNT162b mRNA COVID-19 vaccine in patients with chronic lymphocytic leukemia

Ohad Benjamini, Lior Rokach, Gilad Itchaki, Andrei Braester, Lev Shvidel, Neta Goldschmidt, Shirley Shapira, Najib Dally, Abraham Avigdor, Galia Rahav, Yaniv Lustig, Shirley Shapiro Ben David, Riva Fineman, Alona Paz, Osnat Bairey, Aaron Polliack, Ilana Levy, Tamar Tadmor

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Patients with chronic lymphocytic leukemia (CLL) have a suboptimal humoral response to vaccination. Recently, BNT162b2, an mRNA COVID-19 vaccine with a high efficacy of 95% in immunocompetent individuals, was introduced. We investigated the safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine in patients with CLL from nine medical centers in Israel, Overall 400 patients were included, of whom 373 were found to be eligible for the analysis of antibody response. The vaccine appeared to be safe and only grade 1-2 adverse events were seen in 50% of the patients. Following the second dose, an antibody response was detected in 43% of the cohort. Among these CLL patients, 61% of the treatment-naïve patients responded to the vaccine, while responses developed in only 18% of those with ongoing disease, 37% of those previously treated with a BTK inhibitor and 5% of those recently given an anti-CD20 antibody. Among patients treated with BCL2 as monotherapy or in combination with anti-CD20, 62% and 14%, respectively, developed an immune response. There was a high concordance between neutralizing antibodies and positive serological response to spike protein. Based on our findings we developed a simple seven-factor score including timing of any treatment with anti-CD20, age, treatment status, and IgG, IgA, IgM and hemoglobin levels. The sum of all the above parameters can serve as a possible estimate to predict whether a given CLL patient will develop sufficient antibodies. In conclusion, the BNT162b2 mRNA COVID-19 vaccine was found to be safe in patients with CLL, but its efficacy is limited, particularly in treated patients.

Original languageEnglish
Pages (from-to)625-634
Number of pages10
JournalHaematologica
Volume107
Issue number3
Early online date29 Jul 2021
DOIs
StatePublished - 1 Mar 2022

ASJC Scopus subject areas

  • Hematology

Fingerprint

Dive into the research topics of 'Safety and efficacy of the BNT162b mRNA COVID-19 vaccine in patients with chronic lymphocytic leukemia'. Together they form a unique fingerprint.

Cite this