WUTH publication: Defective T-cell response to COVID-19 vaccination in acute myeloid leukaemia and myelodysplastic syndromes

Citation: British journal of haematology. 2023 Jun 12. 
Author: Loke J; Upasani V; Gaskell C; Fox S; Fletcher R; Thomas C; Hopkins L; Kumari A; Tang T; Yafai E; Boucher R; Homer V; Toth A; Chan YLT; Randall K; Rider T; O'Nions J; Drew V; Pillai A; Dungarwalla M; Murray D; Khan A; Wandroo F; Moore S; Krishnamurthy P; Huang YJ; Knapper S; Byrne J; Zhao R; Craddock C; Parry H; Moss P; Stanworth SJ; Lowe DM; 
Abstract: Limited data exist on COVID-19 vaccination efficacy in patients with acute myeloid leukemia and myelodysplasia with excess blasts (AML/MDS-EB2). We report results from a prospective study, PACE (Patients with AML and COVID-19 Epidemiology). 93 patients provided samples post-vaccine 2 or 3 (PV2, PV3). Antibodies against SARS-COV-2 spike antigen were detectable in all samples. Neutralization of the omicron variant was poorer than ancestral variants but improved PV3. In contrast, adequate T-cell reactivity to SARS-COV-2 spike protein was seen in only 16/47 (34%) patients PV2 and 23/52 (44%) PV3. Using regression models, disease response (not in CR/Cri), and increasing age predicted poor T cell response.