ePoster Presentation 49th Annual Scientific Meeting of the Australian and New Zealand Society for Immunology 2021

Efficacy of COVID-10 Vaccine BNT162b2 in patients with Follicular Lymphoma and Waldenstrom Macroglobulinemia: (#247)

Priyanka Hastak 1 , Brendan Beaton 2 3 , Sarah Sasson 1 4 , Katherine Rankin 2 , Juliette Raedemaeker 2 , Alexander Wong 2 , Andrew Warden 5 , Alberto Ospina Stella 1 , Anupriya Aggarwal 1 , Chansavath Phetsouphanh 1 , Andrew Pettitt 6 , Stuart Turville 1 , Anthony Kelleher 1 , Judith Trotman 2 3 , Fabienne Brilot 7 8 9 , Ian Caterson 10 11
  1. The Kirby Institute, Sydney, NEW SOUTH WALES, Australia
  2. Hematology Department, Concord Repatriation General Hospital, Sydney, Australia, Sydney, New South Wales, Australia
  3. Concord Clinical School, the Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  4. Immunology Department, Westmead Hospital, Sydney, New South Wales, Australia
  5. WMozzies Australian Patient Support Group for Waldenstrom’s Macroglobulinemia, Sydney, New South Wales, Australia
  6. Department of Haematology, University of Liverpool, Liverpool, United Kingdom
  7. Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
  8. Marie Bashir Institute for Biosecurity, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  9. Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research, Children's Hospital at Westmead, Sydney, New South Wales, Australia
  10. Human Nutrition, The University of Sydney, Sydney, New South Wales, Australia
  11. COVID Vaccination Hub, Sydney Local Health District, Sydney, New South Wales, Australia

Introduction:

People with lymphoid malignancies are at increased risk of severe SARS-CoV-2 infection and death. There is limited data on BNT162b2 (Pfizer) vaccine response in patients with lymphoid cancers compared to the general population.

We assessed the vaccine responses to BNT162b2 in Follicular lymphoma (FL) and Waldenstrom Macroglobulinemia (WM) at Baseline (Timepoint 1) and 21 days after first (Timepoint 2) and second (Timepoint 3) dose. Cohort included: 1) 24 FL patients treated with rituximab-chemotherapy (FLT); 2) 11 FL patients’ treatment-naïve (FLN); 3) 15 WM patients with rituximab-chemotherapy (WMT); 4) 13 WM patients treated with Bruton’s Tyrosine Kinase inhibitors (WMB); 5) 9 WM patients’ treatment-naïve (WMN); 6) 13 Healthy controls.

Methodology:

Immune response was measured by flow cytometric detection of anti-SARS-CoV-2 spike antibodies (AsAb), using our established live cell assay, live virus neutralisation to a panel of variants of concern and antigen-specific T cell responses. Statistical analysis of medians between the cohorts were compared using Mann-Whitney non-parametric test.

Results:

No participants had detectable ASAb at Timepoint 1, confirming no prior SARS-CoV-2 exposure. At Timepoint 2, the median mean fluorescence intensity (MFI) of healthy controls: 60802, was significantly higher than all WM: 0 (p<0.0001), and all FL patients: 1687 (p=0.002). The median MFI of controls was significantly higher than WMN (p=0.036), but not higher than FLN (p=0.28). The median MFI of WMN: 20074, was significantly higher than WMB: 0 (p=0.018). Similarly, FLN: 31476, was significantly higher than FLT: 0 (p=0.01).

Discussion:

There was measurable ASAb in all healthy controls post first dose of BNT162b2. Treatment naïve patients had a better response than treated patients. WMB patients had reduced response compared to treatment-naïve patients. FL chemotherapy-rituximab patients had reduced response compared to the treatment-naïve cohort.

This study is ongoing, results to Timepoint 3 will be reported at the ASI conference.