Publication date: Sep 21, 2023
B-cell targeted therapies, including anti-CD20 monoclonal antibodies (mAb) and Bruton’s tyrosine kinase inhibitors (BTKi), further suppress antibody (Ab) response to vaccines in patients with chronic lymphocytic leukemia (CLL). We conducted a prospective cohort study of SARS-CoV-2 vaccination in 81 CLL patients receiving BTKi (n = 54), venetoclax (VEN, n = 9), or who were treatment nacEFve (TN, n = 18). Anti-spike Ab were detected in 53% of patients on BTKi post-primary series and 84% post-booster, 57% of patients on VEN post-primary series and 50% post-booster, and 67% of TN patients post-primary series and 87% post-booster. T-cell response to the primary series was independent of Ab response. At the time of booster, 12 patients interrupted BTKi (median 21 d, range 8-22) and 33 continued BTKi. Among patients with detectable Ab post-booster, those who interrupted BTKi (n = 10) had significantly higher Ab titers (median 7149 units/mL) compared with patients who continued BTKi (n = 27, median 2071 units/mL, p = .04).
| Concepts | Keywords |
|---|---|
| Btki | immunobiology |
| Leukemia | lymphoid leukemia |
| Vaccines | neoplasia |
| T-cell mediated immunity | |
| Vaccines |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | VO | vaccination |
| disease | IDO | cell |
| drug | DRUGBANK | L-Tyrosine |
| disease | MESH | chronic lymphocytic leukemia |
| drug | DRUGBANK | Venetoclax |
| disease | VO | time |
| disease | MESH | lymphoid leukemia |
| disease | MESH | neoplasia |
| disease | IDO | humoral immune response |