RT Journal Article
T1 SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders.
A1 Piñana, José Luis
A1 López-Corral, Lucia
A1 Martino, Rodrigo
A1 Vazquez, Lourdes
A1 Pérez, Ariadna
A1 Martin-Martin, Gabriel
A1 Gago, Beatriz
A1 Sanz-Linares, Gabriela
A1 Sanchez-Salinas, Andrés
A1 Villalon, Lucia
A1 Conesa-Garcia, Venancio
A1 Olave, María T
A1 Corona, Magdalena
A1 Marcos-Corrales, Sara
A1 Tormo, Mar
A1 Hernández-Rivas, José Ángel
A1 Montoro, Juan
A1 Rodriguez-Fernandez, Alicia
A1 Risco-Gálvez, Irene
A1 Rodríguez-Belenguer, Pablo
A1 Hernandez-Boluda, Juan Carlos
A1 García-Cadenas, Irene
A1 Ruiz-García, Montserrat
A1 Muñoz-Bellido, Juan Luis
A1 Solano, Carlos
A1 Cedillo, Ángel
A1 Sureda, Anna
A1 Navarro, David
A1 Infectious Complications Subcommittee of the Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH-TC), 
K1 Allogeneic stem cell transplantation
K1 Autologous stem cell transplantation
K1 Breakthrough SARS-CoV-2 infection
K1 COVID-19
K1 Correlates of protection
K1 Hematological malignancies
K1 Immunocompromised patients
K1 Moderna mRNA-1273
K1 Pfizer-BioNTech BNT162b2
K1 SARS-CoV-2 vaccines
K1 Vaccine
AB The clinical efficacy of SARS-CoV-2 vaccines according to antibody response in immunosuppressed patients such as hematological patients has not yet been established. A prospective multicenter registry-based cohort study conducted from December 2020 to December 2021 by the Spanish transplant and cell therapy group was used to analyze the relationship of antibody response at 3-6 weeks after full vaccination (2 doses) with breakthrough SARS-CoV-2 infection in 1394 patients with hematological disorders. At a median follow-up of 165 days after complete immunization, 37 out of 1394 (2.6%) developed breakthrough SARS-CoV-2 infection at median of 77 days (range 7-195) after full vaccination. The incidence rate was 6.39 per 100 persons-year. Most patients were asymptomatic (19/37, 51.4%), whereas only 19% developed pneumonia. The mortality rate was 8%. Lack of detectable antibodies at 3-6 weeks after full vaccination was the only variable associated with breakthrough infection in multivariate logistic regression analysis (Odds Ratio 2.35, 95% confidence interval 1.2-4.6, p = 0.012). Median antibody titers were lower in cases than in non-cases [1.83 binding antibody units (BAU)/mL (range 0-4854.93) vs 730.81 BAU/mL (range 0-56,800), respectively (p = 0.007)]. We identified 250 BAU/mL as a cutoff above which incidence and severity of the infection were significantly lower. Our study highlights the benefit of developing an antibody response in these highly immunosuppressed patients. Level of antibody titers at 3 to 6 weeks after 2-dose vaccination links with protection against both breakthrough infection and severe disease for non-Omicron SARS-CoV-2 variants.
YR 2022
FD 2022-05-07
LK http://hdl.handle.net/10668/20347
UL http://hdl.handle.net/10668/20347
LA en
DS RISalud
RD Apr 5, 2025