Response to COVID-19 Vaccination Post-CAR T Therapy in Patients With Non-Hodgkin Lymphoma and Multiple Myeloma

Clin Lymphoma Myeloma Leuk. 2023 Jun;23(6):456-462. doi: 10.1016/j.clml.2023.03.002. Epub 2023 Mar 7.

Abstract

COVID-19 adversely affects individuals with cancer. Several studies have found that seroconversion rates among patients with hematologic malignancies are suboptimal when compared to patients without cancer. Patients with non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) are immunocompromised due to impaired humoral and cellular immunity in addition to prescribed immunosuppressive therapy. Chimeric antigen receptor T-cell (CAR T) therapy is now widely used for NHL and MM, but little is known about seroconversion rates after COVID-19 vaccination among these populations. We evaluated SARS-CoV-2 spike-binding IgG antibody levels following COVID-19 vaccination among NHL and MM CAR T therapy recipients. Out of 104 CAR T infusions, 19 patients developed known COVID-19 infection post-CAR T. We tested 17 patients that received CAR T for antibody spike titers post COVID-19 vaccination, only 29 % (n = 5) were able to mount a clinically relevant antibody response (>250 IU/mL).

Keywords: COVID-19 vaccine; Cellular therapy; Dysproteinemia; Immunosuppressed; Lymphoma.

MeSH terms

  • Antibodies, Viral
  • COVID-19 Vaccines / therapeutic use
  • COVID-19* / prevention & control
  • Humans
  • Immunoglobulin G
  • Lymphoma, Non-Hodgkin*
  • Multiple Myeloma* / drug therapy
  • Receptors, Chimeric Antigen*
  • SARS-CoV-2

Substances

  • Receptors, Chimeric Antigen
  • COVID-19 Vaccines
  • Antibodies, Viral
  • Immunoglobulin G