COVID‐19 elicits an impaired antibody response against SARS‐CoV‐2 in patients with haematological malignancies
Francesco Passamonti, Alessandra Romano, Marco Salvini, Francesco Merli, Matteo Giovanni Della Porta, Riccardo Bruna, Elisa Coviello, Ilaria Romano, Roberto Cairoli, Roberto M. Lemoli, Francesca Farina, Adriano Venditti, Alessandro Busca, Marco Ladetto, Massimo Massaia, Antonio Pinto, Luca Arcaini, Agostino Tafuri, Francesco Marchesi, Nicola Stefano Fracchiolla, Monica Bocchia, Daniele Armiento, Anna Candoni, Mauro Krampera, Mario Luppi, Valeria Cardinali, Sara Galimberti, Chiara Cattaneo, Elettra Ortu La Barbera, Roberto Mina, Francesco Lanza, Giuseppe Visani, Pellegrino Musto, Luigi Petrucci, Francesco Zaja, Paolo Grossi, Lorenza Bertù, Livio Pagano, Paolo Corradini, the ITA-HEMA-COV Investigators*
Abstract
COVID-19 is associated with high mortality in patients with haematological malignancies (HM) and rate of seroconversion is unknown. The ITA-HEMA-COV project (NCT04352556) investigated patterns of seroconversion for SARS-CoV-2 IgG in patients with HMs. A total of 237 patients, SARS-CoV-2 PCR-positive with at least one SARS-CoV-2 IgG test performed during their care, entered the analysis. Among these, 62 (26·2%) had myeloid, 121 (51·1%) lymphoid and 54 (22·8%) plasma cell neoplasms. Overall, 69% of patients (164 of 237) had detectable IgG SARS-CoV-2 serum antibodies. Serologically negative patients (31%, 73 of 237) were evenly distributed across patients with myeloid, lymphoid and plasma cell neoplasms. In the multivariable logistic regression, chemoimmunotherapy [odds ratio (OR), 3·42; 95% confidence interval (CI), 1·04-11·21; P = 0·04] was associated with a lower rate of seroconversion. This effect did not decline after 180 days from treatment withdrawal (OR, 0·35; 95% CI: 0·11-1·13; P = 0·08). This study demonstrates a low rate of seroconversion in HM patients and indicates that treatment-mediated immune dysfunction is the main driver. As a consequence, we expect a low rate of seroconversion after vaccination and thus we suggest testing the efficacy of seroconversion in HM patients.