Deficiency of SARS-CoV-2 T-cell responses after vaccination in long-term allo-HSCT survivors translates into abated humoral immunity
Journal article, 2022

Recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for hematological diseases are at risk of severe disease and death from COVID-19. To determine the safety and immunogenicity of BNT162b2 and mRNA-1273 COVID-19 vaccines, samples from 50 infection-naive allo-HSCT recipients (median, 92 months from transplantation, range, 7-340 months) and 39 healthy controls were analyzed for serum immunoglobulin G (IgG) against the receptor binding domain (RBD) within spike 1 (S1) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; anti–RBD-S1 IgG) and for SARS-CoV-2–specific T-cell immunity, reflected by induction of T-cell–derived interferon-g in whole blood stimulated ex vivo with 15-mer SI-spanning peptides with 11 amino acid overlap S1-spanning peptides. The rate of seroconversion was not significantly lower in allo-transplanted patients than in controls with 24% (12/50) and 6% (3/50) of patients remaining seronegative after the first and second vaccination, respectively. However, 58% of transplanted patients lacked T-cell responses against S1 peptides after 1 vaccination compared with 19% of controls (odds ratio [OR] 0.17; P 5 .009, Fisher’s exact test) with a similar trend after the second vaccination where 28% of patients were devoid of detectable specific T-cell immunity, compared with 6% of controls (OR 0.18; P 5 .02, Fisher’s exact test). Importantly, lack of T-cell reactivity to S1 peptides after vaccination heralded substandard levels (,100 BAU/mL) of anti–RBD-S1 IgG 5 to 6 months after the second vaccine dose (OR 8.2; P 5 .007, Fisher’s exact test). We conclude that although allo-HSCT recipients achieve serum anti–RBD-S1 IgG against SARS-CoV-2 after 2 vaccinations, a deficiency of SARS-CoV-2–specific T-cell immunity may subsequently translate into insufficient humoral responses.

Author

Sigrun Einarsdottir

University of Gothenburg

Anna Martner

University of Gothenburg

Jesper Waldenström

Sahlgrenska University Hospital

University of Gothenburg

Malin Nicklasson

University of Gothenburg

Johan Ringlander

University of Gothenburg

Sahlgrenska University Hospital

Mohammad Arabpour

University of Gothenburg

Sahlgrenska University Hospital

Andreas Törnell

University of Gothenburg

Hanna Grauers Wiktorin

University of Gothenburg

Staffan Nilsson

Chalmers, Mathematical Sciences, Applied Mathematics and Statistics

University of Gothenburg

Rudy Bittar

University of Gothenburg

Malin S. Nilsson

Sahlgrenska University Hospital

Mikael Lisak

University of Gothenburg

Malin Veje

University of Gothenburg

Vanda Friman

University of Gothenburg

Samer Al-Dury

Wallenberg Lab.

Tomas Bergström

Sahlgrenska University Hospital

University of Gothenburg

Per Ljungman

Karolinska University Hospital

Karolinska Institutet

Mats Brune

University of Gothenburg

Kristoffer Hellstrand

Sahlgrenska University Hospital

University of Gothenburg

Martin Lagging

Sahlgrenska University Hospital

University of Gothenburg

Blood Advances

24739529 (ISSN) 24739537 (eISSN)

Vol. 6 9 2723-2730

Subject Categories

Infectious Medicine

Immunology in the medical area

Gastroenterology and Hepatology

Hematology

DOI

10.1182/bloodadvances.2021006937

PubMed

35286374

More information

Latest update

10/30/2023