Sars-Cov-2 Antibody and T-Cell Responses in Patients with Paroxysmal Nocturnal Hemoglobinuria and Aplastic Anemia after Four COVID-19 Vaccinations

Introduction: There is limited data on SARS-CoV-2 vaccination responses in the rare hematological disorders paroxysmal nocturnal hemoglobinuria (PNH) and aplastic anemia (AA). These patients were expected to have more severe COVID-19 infection and reduced vaccination responses due to their underlyin...

Full description

Saved in:

Bibliographic Details
Published in:	Blood 2023-11, Vol.142 (Supplement 1), p.2712-2712
Main Authors:	Pike, Alexandra, Fox, Natalie, McKinley, Claire E, Arnold, Louise M, Harland, Mark, Clarke, Deborah, Forrest, Briony, Houghton, Nicola, Youngs, Nora, Charlton, Emily, Zhakata, Tapiwa, Barnfield, Catherine, Harvey, Ruth, Wu, Mary, Kavanagh, Caitlin, Richards, Stephen John, Payne, Daniel, Varghese, Abraham Mullasseril, Nagumantry, Sateesh, Munir, Talha, Muus, Petra, Griffin, Morag, Newton, Darren, Hillmen, Peter, Kelly, Richard J
Format:	Article
Language:	eng
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Introduction: There is limited data on SARS-CoV-2 vaccination responses in the rare hematological disorders paroxysmal nocturnal hemoglobinuria (PNH) and aplastic anemia (AA). These patients were expected to have more severe COVID-19 infection and reduced vaccination responses due to their underlying disease and immunosuppressive treatment. We previously reported limited anti-spike IgA/G/M responses after first COVID-19 vaccination which improved following second vaccination (Pike et al, Lancet Haematology 2022). Here we report spike-specific IgG, in vitro viral neutralization and T-cell responses in 244 patients with PNH and/or AA and in 49 healthy volunteers, following the first four vaccinations. Methods: In 2021, the United Kingdom National PNH service centre based in Leeds initiated a prospective observational non-interventional study evaluating immune responses to COVID-19 vaccinations in patients with PNH and/or AA. All patients were consented to the Leeds PNH Research Tissue Bank. At baseline, the patient cohort comprised 94 patients with classic PNH, 75 with AA-PNH overlap and 75 with AA with asymptomatic PNH clones 0.99). After first vaccination, 2/40 (5%) healthy volunteers and 66/155 (42.6%) PNH and AA patients failed to mount a detectible spike-specific IgG. The antibody titre was also significantly reduced (median spike-specific IgG titre in patients 37.9 BAU/ml [IQR 11.56-120.7] versus 289.4 BAU/ml in healthy volunteers [IQR 177.7-1326], p
ISSN:	0006-4971 1528-0020