Third primary SARS-CoV-2 mRNA vaccines enhance antibody responses in most patients with haematological malignancies

Lucy B. Cook, Gillian O’Dell, Eleni Vourvou, Renuka Palanicawandar, Sasha Marks, Dragana Milojkovic, Jane F. Apperley, Sandra Loaiza, Simone Claudiani, Marco Bua, Catherine Hockings, Donald Macdonald, Aris Chaidos, Jiri Pavlu, Nichola Cooper, Sarah Fidler, Paul Randell and Andrew J. Innes ()
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Lucy B. Cook: Imperial College London
Gillian O’Dell: Imperial College Healthcare NHS Trust
Eleni Vourvou: Imperial College Healthcare NHS Trust
Renuka Palanicawandar: Imperial College Healthcare NHS Trust
Sasha Marks: Imperial College Healthcare NHS Trust
Dragana Milojkovic: Imperial College London
Jane F. Apperley: Imperial College London
Sandra Loaiza: Imperial College Healthcare NHS Trust
Simone Claudiani: Imperial College Healthcare NHS Trust
Marco Bua: Imperial College Healthcare NHS Trust
Catherine Hockings: Imperial College Healthcare NHS Trust
Donald Macdonald: Imperial College London
Aris Chaidos: Imperial College London
Jiri Pavlu: Imperial College Healthcare NHS Trust
Nichola Cooper: Imperial College London
Sarah Fidler: Imperial College London
Paul Randell: North West London Pathology
Andrew J. Innes: Imperial College London

Nature Communications, 2022, vol. 13, issue 1, 1-6

Abstract: Abstract SARS-CoV-2 infection, and resulting disease, COVID-19, has a high mortality amongst patients with haematological malignancies. Global vaccine rollouts have reduced hospitalisations and deaths, but vaccine efficacy in patients with haematological malignancies is known to be reduced. The UK-strategy offered a third, mRNA-based, vaccine as an extension to the primary course in these patients. The MARCH database is a retrospective observational study of serological responses in patients with blood disorders. Here we present data on 381 patients with haematological malignancies. By comparison with healthy controls, we report suboptimal responses following two primary vaccines, with significantly enhanced responses following the third primary dose. These responses however are heterogeneous and determined by haematological malignancy sub-type and therapy. We identify a group of patients with continued suboptimal vaccine responses who may benefit from additional doses, prophylactic extended half-life neutralising monoclonal therapies (nMAB) or prompt nMAB treatment in the event of SARS-CoV-2 infection.

Date: 2022
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DOI: 10.1038/s41467-022-34657-z

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