Table 1.
Summary of studies evaluating SARS-CoV-2 vaccine responses in patients with hematologic malignancies.
| Year, citation | Vaccination type, # of doses | # of subjects (# and type of Heme malignancy) |
Test groups | Age at immunization | Spike IgG or NAb test | Seropositivity, days after completion of vaccine | SARS-CoV-2 IgG antibody titer or NAb inhibition titer | Safety & Reactogenicity |
|---|---|---|---|---|---|---|---|---|
| 2021 Chowdhury et al. |
BNT162b2 or ChAdOx1 1 dose |
N = 59 | HM (myeloid neoplasm only) Healthy controls (N = 232) |
Median years: Myeloid malignancy: 62 Controls: 62 |
Abbott IgG II Quant Assay | HM: 34/59 (58%) Controls: 224/232 (97%) >14 days |
Median (AU/mL) HM: 75 Controls: 630 |
No significant events reported |
| 2021 Addeo et al. |
BNT162b2 or mRNA-1273 2 doses 3–4 weeks apart |
N = 131 (HM = 25) |
HM Solid tumor |
Median years: 63 |
Roche Elecsys SARS-CoV-2 anti-S RBD IgG | After dose 1: HM: 18/25 (72%) Solid: 80/96 (83%) After dose 2: HM: 17/22 (77%) Solid: 99/101 (98%) 21–28 days after each vaccine dose |
Median (AU/mL) After dose 1: HM: 6 Solid: 44 After dose 2: HM: 832 Solid: 2500 |
Not reported |
| 2021 Agha et al. |
BNT162b2 or mRNA-1273 2 doses 3–4 weeks apart |
N = 67 | HM | Median years: 71 |
Beckman Coulter (semi-quantitative) | 36/67 (54%) Median days after 2nd dose: 23 (IQR 16–31 days) |
Median (extinction coefficient): 14.42 |
Not reported |
| 2021 Greenberger et al. |
BNT162b2 or mRNA-1273 2 doses 3–4 weeks apart |
N = 1445 | HM | Median years: 68 |
Roche Elecsys SARS-CoV-2 anti-S RBD IgG | 1088/1445 (75%) >14 days (median 41 or 42 depending on vaccine type) |
Not reported | Not reported |
| 2021 Herzog Tzarfati et al. |
BNT162b2 2 doses 3 weeks apart |
N = 315 | HM Non-malignancy controls (N = 108) |
Median years: HM: 71 Controls: 69 |
Diasorin Liaison SARS-CoV-2 S1/S2 IgG | HM: 235 (75%) Controls: 107 (99%) 30–60 days |
Median (AU/mL) HM: 85 Controls: 157 |
Not reported |
| 2021 Malard et al. |
BNT162b2 2 doses 3–4 weeks apart |
N = 195 | HM | Median years: 69 |
Abbott IgG II Quant Assay | Based on study-specific cutoff derived from NAb association After dose 1: 1.5% After dose 2: 46.7% 14 days |
Not reported | After 1st dose 57.1% had grade 1–2 adverse effects After 2nd dose 34.4% had grade 1–2 adverse effects, 8.4% with grade 3 |
| 2021 Monin et al. |
BNT162b2 2 doses 3 weeks apart |
N = 151 (HM = 56) |
HM Solid tumor Healthy controls (N = 54) |
Median years Cancer: 73 Controls: 41 |
ELISA for anti-spike IgG | 21 days after dose 1: HM: 8/44 (18%) Solid: 21/56 (38%) Controls: 32/34 (94%) 14 days after dose 2: HM: 3/5 (60%) Solid: 18/19 (95%) Controls: 12/12 (100%) |
Numerical value not reported | After 1st dose: Local: 36% Systemic: 25% After 2nd dose: Local: 23% Systemic: 14% Majority were grade 1–2 events |
| 2021 Peeters et al. |
BNT162b2 2 doses 3 weeks apart |
N = 240 (HM = 30 SCT = 11) |
HM (receiving rituximab) SCT Solid tumor |
Median years: Cohort: 61 HM and SCT: 61 Controls not reported |
Wantai ELISA for anti-S RBD IgG | Not reported 28 days |
GMT (IU/mL) HM (includes SCT): 17.61 Rituximab: 4.12 SCT: 610.67 Healthy controls: 2955.04 |
For entire cohort: 1–3% with severe reactogenicity. Local symptoms were more common after 2nd dose than 1st dose while systemic reactions appeared equally after both doses. |
| 2021 Re et al. |
BNT162b2 or mRNA-1273 2 doses 3–4 weeks apart |
N = 102 | HM | Median years: 75.5 |
Not reported | 63/102 (61.8%) 6–8 weeks after vaccine dose 1 |
Median (UI/mL) 16.8 |
Not reported |
| 2021 Thakkar et al. |
BNT162b2 or mRNA-1273 2 doses 3–4 weeks apart or Ad26.COV2.S 1 dose |
N = 185 (HM = 59) |
HM Solid tumor Non-malignancy controls (N = 26) |
Median years: Malignancy: 67 Controls: 64 |
Abbott IgG II Quant Assay | HM: 56 (85%) Solid: 131 (98%) Controls: not reported >7 days (Median 31.5 for solid and 28.5 for HM) |
Median (AU/mL) HM: 2528 Solid: 7858 Controls: value not reported |
26–37% with mild to moderate adverse effects after 1 or 2 doses of vaccine 1–3% with severe adverse effects after 1 or 2 doses of vaccine |
| 2021 Bird et al. |
BNT162b2 or ChAdOx1 1 dose |
N = 93 | MM | Median years: 67 |
Ortho Clinical Diagnostic | 52/93 (56%) >21 days |
Not reported | Not reported |
| 2021 Terpos et al. |
BNT162b2 1 dose |
N = 48 | MM Healthy controls (N = 104) |
Median years MM: 83 Controls: 83 |
GenScript Neutralizing Ab kit |
MM: 12/48 (25%) Controls: 57/104 (55%) 21 days |
Median inhibition titer (%) MM: 20.6% Controls: 32.5% |
Not reported |
| 2021 Avivi et al. |
BNT162b2 2 doses 3 weeks apart |
N = 171 | MM Healthy controls (N = 64) |
Median years: MM: 70 Controls: 67 |
Roche Elecsys SARS-CoV-2 anti-S RBD IgG | MM: 133/171 (78%) Controls: 63/64 (98%) 14–21 days |
Median (U/mL) Active MM: 91 Smouldering MM: 822 Controls: 992 |
≥1 vaccine related adverse event: MM: 53% Controls: 55% All grade 1–2 |
| 2021 Pimpinelli et al. |
BNT162b2 2 doses 3 weeks apart |
N = 92 (MM = 42 MPM = 50) |
MM MPM Elderly controls (N = 36) |
Median years: MM: 73 MPM: 70 Controls: 81 |
Diasorin Liaison SARS-CoV-2 S1/S2 IgG | 21 days after dose 1: MM: 9/42 (21%) MPM: 26/50 (52%) Controls: 19/36 (53%) 14 days after dose 2: MM: 33/42 (79%) MPM: 44/50 (88%) Controls: 36/36 (100%) |
Mean (AU/mL) After dose 1: MM: 7.5 MPM: 16.2 Controls: 17.1 After dose 2: MM: 106.7 MPM: 172.9 Controls: 353.3 |
After 1st dose there were mild local side effects and mild to moderate systemic effects Increased % mild to moderate local and systemic effects after 2nd dose than after 1st dose |
| 2021 Van Oekelen et al. |
BNT162b2 or mRNA-1273 2 doses (3.8% unknown type mRNA vaccine) |
N = 320 | MM | Median years: 68 |
Kantaro COVID-SeroKlir | 219/260 (84%) >10 days (median 51 days) |
Median (AU/mL) SARS-CoV-2-naïve: 149 Prior SARS-CoV-2: 801 |
Not reported |
| 2021 Gavriatopoulou et al. |
BNT162b2 or ChAdOx1 1 dose |
N = 58 | WM/CLL/NHL Healthy controls (N = 213) |
Median years: HM: 75 Controls: 75 |
GenScript Neutralizing Ab kit | ≥50% inhibition titer WM/CLL/NHL: 3/58 (5%) Controls: 50/213 (23%) 21 days |
Median inhibition titer (%) WM/CLL/NHL: 17% Controls: 32% |
Not reported |
| 2021 Herishanu et al. |
BNT162b2 2 doses 3 weeks apart |
N = 167 | CLL Healthy controls (N = 52) |
Median years: CLL: 71 Controls: 68 |
Roche Elecsys SARS-CoV-2 anti-S RBD IgG | CLL: 66/167 (40%) Controls: 100% 14–21 days |
Median (AU/mL) CLL: 0.824 Controls: 1084 |
After 1st dose: Local: 31% Systemic: 13% After 2nd dose: Local: 34% Systemic: 23% All were mild reactions |
| 2021 Roeker et al. |
BNT162b2 or mRNA-1273 2 doses |
N = 44 | CLL | Median years: 71 |
Diasorin Liaison SARS-CoV-2 S1/S2 IgG | 23/44 (52%) 14–28 days |
Not reported | Not reported |
| 2021 Ghione et al. |
BNT162b2 or mRNA-1273 2 doses or Ad26.COV2.S 1 dose |
N = 86 | Lymphoma Nursing home residents >65y (N = 47) Health care workers <65y (N = 154) |
Median years: Lymphoma: 70 Not reported for controls |
Anti-spike RBD chemiluminescence immunoassay from KSL diagnostics | Lymphoma:36/86 (42%) Control >65y: 43/47 (91%) Control <65y: 154/154 (100%) 14–56 days |
Numerical value not reported | Not reported |
| 2021 Lim et al. |
ChAdOx1 or BNT162b2 2 doses 10–12 weeks apart |
N = 129 | Lymphoma Healthy controls (N = 150) |
Median years: Lymphoma: 69 Controls: 45 |
Meso Scale Discovery electro-chemiluminescent assay | Lymphoma on treatment: 9/31 (29%) after 1 dose 13/33 (39%) after 2 doses Lymphoma without treatment numbers not reported Controls: 150/150 (100%) after 1 or 2 doses 14 days after 1 dose 14–28 days after 2 doses |
GMT (BAU/mL) after 2 doses Lymphoma on treatment: 2.5 Lymphoma without treatment: 141.8 Controls: not reported |
Not reported |
| 2021 Harrington et al. |
BNT162b2 1 dose |
N = 16 | CML | Median years: 45 |
ELISA for SARS-CoV-2 anti-spike IgG | 14/16 (88%) 21 days |
Median (EC50) 100.5 |
Local: 56% Systemic: 24% |
| 2021 Kozak et al. |
BNT162b2 or mRNA-1273 2 doses 3–4 weeks apart |
N = 74 | MPM | Median years: 68 |
Abbott IgG II Quant Assay | 71/74 (96%) Median 100 days |
Reported only for certain subgroups | Not reported |
| 2021 Greenberger et al. October 2021 |
Homologous (33%) or heterologous (67%) booster after full mRNA-1273, BNT162b2, or AD26.COV2.S | N = 49 | B-cell malignancies | Average years: 66 |
Roche Elecsys SARS-CoV-2 anti-S RBD IgG | Pre-booster baseline (median 27 days before booster): 11/49 (22%) Post-booster (median 28 days): 32/49 (65%) |
Median (AU/mL) after booster Seronegative: <0.4 Sero-conversion: 23.1 Sero-elevation: 2500 |
Not reported |
Abbreviations
CLL = chronic lymphocytic leukemia.
HM = Hematological malignancy.
MM = multiple myeloma.
MPM = myeloproliferative malignancy.
NHL = non-Hodgkin's lymphoma.
RBD = receptor binding domain.
WM = Waldenstrom macroglobulinemia.