TY - JOUR
T1 - COVID-19 mRNA Vaccine in Patients With Lymphoid Malignancy or Anti-CD20 Antibody Therapy
T2 - A Systematic Review and Meta-Analysis
AU - Ito, Yusuke
AU - Honda, Akira
AU - Kurokawa, Mineo
N1 - Funding Information:
Y.I. declares no competing financial interests. A.H. reports honoraria from Janssen Pharmaceutical. M.K. reports honoraria from AstraZeneca, Chugai Pharmaceutical, Janssen Pharmaceutical, Sanofi, and Pfizer, and research funding from Chugai Pharmaceutical and Pfizer.
Publisher Copyright:
© 2022
PY - 2022/8
Y1 - 2022/8
N2 - Background: The humoral response to vaccination in individuals with lymphoid malignancies or those undergoing anti-CD20 antibody therapy is impaired, but details of the response to mRNA vaccines to protect against COVID-19 remain unclear. This systematic review and meta-analysis aimed to characterize the response to COVID-19 mRNA vaccines in patients with lymphoid malignancies or those undergoing anti-CD20 antibody therapy. Materials and Methods: A literature search retrieved 52 relevant articles, and random-effect models were used to analyze humoral and cellular responses. Results: Lymphoid malignancies and anti-CD20 antibody therapy for non-malignancies were significantly associated with lower seropositivity rates (risk ratio 0.60 [95% CI 0.53-0.69]; risk ratio 0.45 [95% CI 0.39-0.52], respectively). Some subtypes (chronic lymphocytic leukemia, treatment-naïve chronic lymphocytic leukemia, myeloma, and non-Hodgkin's lymphoma) exhibited impaired humoral response. Anti-CD20 antibody therapy within 6 months of vaccination decreased humoral response; moreover, therapy > 12 months before vaccination still impaired the humoral response. However, anti-CD20 antibody therapy in non-malignant patients did not attenuate T cell responses. Conclusion: These data suggest that patients with lymphoid malignancies or those undergoing anti-CD20 antibody therapy experience an impaired humoral response, but cellular response can be detected independent of anti-CD20 antibody therapy. Studies with long-term follow-up of vaccine effectiveness are warranted (PROSPERO registration number: CRD42021265780).
AB - Background: The humoral response to vaccination in individuals with lymphoid malignancies or those undergoing anti-CD20 antibody therapy is impaired, but details of the response to mRNA vaccines to protect against COVID-19 remain unclear. This systematic review and meta-analysis aimed to characterize the response to COVID-19 mRNA vaccines in patients with lymphoid malignancies or those undergoing anti-CD20 antibody therapy. Materials and Methods: A literature search retrieved 52 relevant articles, and random-effect models were used to analyze humoral and cellular responses. Results: Lymphoid malignancies and anti-CD20 antibody therapy for non-malignancies were significantly associated with lower seropositivity rates (risk ratio 0.60 [95% CI 0.53-0.69]; risk ratio 0.45 [95% CI 0.39-0.52], respectively). Some subtypes (chronic lymphocytic leukemia, treatment-naïve chronic lymphocytic leukemia, myeloma, and non-Hodgkin's lymphoma) exhibited impaired humoral response. Anti-CD20 antibody therapy within 6 months of vaccination decreased humoral response; moreover, therapy > 12 months before vaccination still impaired the humoral response. However, anti-CD20 antibody therapy in non-malignant patients did not attenuate T cell responses. Conclusion: These data suggest that patients with lymphoid malignancies or those undergoing anti-CD20 antibody therapy experience an impaired humoral response, but cellular response can be detected independent of anti-CD20 antibody therapy. Studies with long-term follow-up of vaccine effectiveness are warranted (PROSPERO registration number: CRD42021265780).
KW - B-cell target therapy
KW - Cellular response
KW - CLL
KW - Humoral response
KW - Seropositivity
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U2 - 10.1016/j.clml.2022.03.012
DO - 10.1016/j.clml.2022.03.012
M3 - Article
C2 - 35459624
AN - SCOPUS:85128587031
SN - 2152-2650
VL - 22
SP - e691-e707
JO - Clinical Lymphoma
JF - Clinical Lymphoma
IS - 8
ER -
