Page 174 - Haematologica May 2022

Letters to the Editor
Table 1. Clinical characteristics of patients evaluable for analysis 2 weeks following two primary vaccine doses.
Total numbers
Age
Median (Q1-Q3) years
All MDS patients
38
67.5 (59-73)
BNT162b2 vaccinated MDS patients
16
69 (60-73)
ChAdOx1 vaccinated MDS
22
67 (63-72)
BNT162b2 vaccinated healthy volunteers
30
35 (27-49)
Sex
Male 23/38(61%) Female 15/38 (39%)
Race
Caucasian 36/38 (95%)
BAME 2/38(5%) 0 2 11
13 10 19 3 12 11
16 20 19
Median time from vaccine first dose to second dose Median (Q1-Q3) days
Median time from vaccine second dose to blood sampling
Median (Q1-Q3) days
MDS WHO subtypes
MDS with single lineage dysplasia
MDS with ring sideroblasts
MDS with isolated del5q
MDS with multilineage dysplasia
MDS with multilineage dysplasia (hypo) MDS with excess blasts
Chronic myelomonocytic leukemia
IPSS-R prognostic categories
Low risk (low/very low/intermediate) High risk (high/very high)
Treatment 15 days pre- and post-vaccination Transfusion support only or watch &wait Growth factors/ TPO mimetics Cyclosporin
5-Azacytidine Others*
75 (68-80)
19 (16-28)
2/38 (5.2%) 5/38 (13.2%) 1/38 (2.6%) 20/38 (52.6%) 4/38 (10.5%)
5/38 (13.2%) 1/38 (2.6%)
30/38 (78.9%) 8/38 (21.1%)
22/38 (57.9%) 6/38 (15.8%) 3/38 (7.9%) 5/38 (13.2%) 1/38 (5.2%)
71 (68-77)
21 (18-30)
0 1 0 9
2 3 1
11 5
7/16 3/16 2/16 3/16
1/16
78 (70-80)
18 (15-24)
2 4 1 11
2 2 0
19 3
15/22 3/22 1/22 2/22
0/22
74 (61-78) 14 (13-17)
*This patient had concurrent chronic lymphocytic leukemia which was the indication for therapy with venetoclax and rituximab. MDS: myelodysplastic syndrome; WHO: World Health Organization; BAME: Black, Asian and minority ethnic; Q: quarter; TPO: thrombopoietin; IPSS-R: Revised International Prognostic Scoring System.
Figure 1. Humoral responses to BNT162b2 COVID-19 and ChAdOx1 nCoV-19 in patients with myelodysplastic syndromes. (A) Serum concentrations of immunoglobulin G (IgG) antibodies reactive to the spike protein of SARS-CoV-2 (S IgG) with cases positive for nucleorprotein N IgG removed. Healthy volunteer (HV; n=26), myelodysplastic syndrome (MDS) patients vaccinated with ChAdOx1 (MDS ChAdOx1; n=20), MDS patients vaccinated with BNT162b2 (MDS BNT162b2; n=15). Mean (95% confidence interval [CI]): healthy volunteers (HV) 3,611 (2,455-4,768), MDS ChAdOx1 360.9 (149.9-572.2) and MDS BNT162b2 3781 (523.9-7,037). Dashed line represents seroconversion threshold. Tukey’s multiple comparison’s test. (B) Neutralization of variants (as indicated in red) by plasma antibodies. Dashed line represents neutralization threshold. Individual cases on the threshold line are colored as indicated, as are their matched responses to other variants. HV (n=26); MDS ChAdOx1 (n=15); MDS BNT162b2 (n=15). Tukey’s multiple comparison’s test. (C) Correlation matrices showing serum S IgG 50% effective dose (ED50) (log) against neutralization for each indicated variant in the MDS ChAdOx1 (n=20) and MDS BNT162b2 (n=15) cohorts. Correlation coefficients (rho;r) and P-values are given. Dashed lines represent threshold as previously described. Pearson’s correlation test. WT: Wuhan strain.
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