Defective T-cell response to COVID-19 vaccination in acute myeloid leukaemia and myelodysplastic syndromes.
Loke J., Upasani V., Gaskell C., Fox S., Fletcher R., Thomas C., Hopkins L., Kumari A., Tang T., Yafai E., Boucher R., Homer V., Toth A., Chan YLT., Randall K., Rider T., O'Nions J., Drew V., Pillai A., Dungarwalla M., Murray D., Khan A., Wandroo F., Moore S., Krishnamurthy P., Huang Y-WJ., Knapper S., Byrne J., Zhao R., Craddock C., Parry H., Moss P., Stanworth SJ., Lowe DM.
Limited data exist on COVID-19 vaccination efficacy in patients with acute myeloid leukemia and myelodysplasia with excess blasts (AML/MDS-EB2). We report results from a prospective study, PACE (Patients with AML and COVID-19 Epidemiology). 93 patients provided samples post-vaccine 2 or 3 (PV2, PV3). Antibodies against SARS-COV-2 spike antigen were detectable in all samples. Neutralization of the omicron variant was poorer than ancestral variants but improved PV3. In contrast, adequate T-cell reactivity to SARS-COV-2 spike protein was seen in only 16/47 (34%) patients PV2 and 23/52 (44%) PV3. Using regression models, disease response (not in CR/Cri), and increasing age predicted poor T cell response.