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<p>This single-center, retrospective study analyzed vaccine responses in patients who received post-Chimeric Antigen Receptor (CAR) T-cell therapy vaccination between 2018 and 2024. Vaccinations were administered according to EBMT/CIBMTR recommendations and pathogen-specific IgG responses to 12 vaccine-preventable infections were assessed. Seroprotection was defined by established cut-offs or a significant fold increase in titers. A total of 73 patients that had not received intravenous immunoglobulins within the eight weeks prior to pre- or post titer were included. The median time to vaccination initiation was 13 months (range 6–66) post-CAR T. Pre and post-vaccination titers were available for 49 patients. Pre-vaccination seroprotection was high (&gt; 85%) for tetanus and poliovirus. Among patients not seroprotected prior to vaccination, vaccine response rates were high for tetanus and polio (100%), moderate for diphtheria (75%) and haemophilus influenzae type b (62%), and lower for pertussis (48%), hepatitis A (43%), hepatitis B (44%), and pneumococcal disease (33%). CD19 CAR T recipients had higher pre-vaccination seroprotection rates than BCMA recipients, but vaccine responses did not differ significantly between groups. Pre-vaccination IgA levels were significantly associated with vaccine response, and absolute B-cell counts trended higher among responders (<i>p</i> = 0.054). Our findings highlight the importance of immune reconstitution in vaccine responses post-CAR T.</p>

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Humoral vaccine responses following Chimeric Antigen Receptor T-cell therapy for hematological malignancies

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月2日

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  • Sigrun Einarsdottir,
  • Stephanie Lobaugh,
  • Danny Luan,
  • Marina Gomez-Llobell,
  • Padmapriya Subramanian,
  • Sean Devlin,
  • David Chung,
  • Parastoo B. Dahi,
  • Lorenzo Falchi,
  • Sergio Giralt,
  • Heather Landau,
  • Alexander M. Lesokhin,
  • Richard Lin,
  • Jennifer Lue,
  • Sham Mailankody,
  • M. Lia Palomba,
  • Jae H. Park,
  • Gilles Salles,
  • Michael Scordo,
  • Silvia Escribano-Serrat,
  • Jaime Sanz,
  • Kai Rejeski,
  • Roni Shouval,
  • Saad Usmani,
  • Miguel-Angel Perales,
  • Gunjan Shah,
  • Zainab Shahid

摘要

This single-center, retrospective study analyzed vaccine responses in patients who received post-Chimeric Antigen Receptor (CAR) T-cell therapy vaccination between 2018 and 2024. Vaccinations were administered according to EBMT/CIBMTR recommendations and pathogen-specific IgG responses to 12 vaccine-preventable infections were assessed. Seroprotection was defined by established cut-offs or a significant fold increase in titers. A total of 73 patients that had not received intravenous immunoglobulins within the eight weeks prior to pre- or post titer were included. The median time to vaccination initiation was 13 months (range 6–66) post-CAR T. Pre and post-vaccination titers were available for 49 patients. Pre-vaccination seroprotection was high (> 85%) for tetanus and poliovirus. Among patients not seroprotected prior to vaccination, vaccine response rates were high for tetanus and polio (100%), moderate for diphtheria (75%) and haemophilus influenzae type b (62%), and lower for pertussis (48%), hepatitis A (43%), hepatitis B (44%), and pneumococcal disease (33%). CD19 CAR T recipients had higher pre-vaccination seroprotection rates than BCMA recipients, but vaccine responses did not differ significantly between groups. Pre-vaccination IgA levels were significantly associated with vaccine response, and absolute B-cell counts trended higher among responders (p = 0.054). Our findings highlight the importance of immune reconstitution in vaccine responses post-CAR T.