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Antibody response after third dose of COVID-19 mRNA vaccination in allogeneic hematopoietic stem cell transplant recipients is comparable to that in healthy counterparts

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Abstract

To determine the efficacy of SARS-CoV-2 mRNA vaccination for allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients, we measured antibody titer serially in 92 allo-HSCT patients. Among the evaluable 87 patients, median age at vaccination was 53 years (range, 18–75). The average time between allo-HSCT and vaccination was 3.3 years (range, 0.5–15.7). One month after the second dose, 70 patients (80.5%) had a positive response, whereas 17 patients (19.5%) had a negative response (< 20 U/mL). Only patients older than 44 years had a negative response. Low IgM level was the only significant predictor of vaccine failure in elderly patients. When antibody response before and after the third vaccination was examined in 47 patients, antibodies increased significantly from a median of 18.3 U/mL to 312.6 U/mL (P < 0.01). The median antibody titer after the third vaccination of healthy individuals (n = 203) was 426.4 U/mL, which was comparable to that of patients (P = 0.2). The antibody titer after the third mRNA vaccination increased even in patients whose first two mRNA vaccinations failed. These findings suggest that allo-HSCT recipients should receive the mRNA vaccine regularly.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank Sayoko Ogata and Saori Takagi for their laboratory work.

Funding

This work was supported by grants from the Japan Society for the Promotion of Science (JSPS) KAKENHI (22k08501 to S.T.).

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Authors and Affiliations

  1. Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan

    Erina Takagi, Seitaro Terakura, Ryo Hanajiri, Makoto Murata & Hitoshi Kiyoi

  2. Department of Advanced Diagnostic System Development, Fujita Health University Graduate School of Health Sciences, Toyoake, Japan

    Hidetsugu Fujigaki & Kuniaki Saito

  3. Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan

    Akinao Okamoto & Akihiro Tomita

  4. Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan

    Kotaro Miyao & Masashi Sawa

  5. Department of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan

    Takanobu Morishita, Tatsunori Goto, Yukiyasu Ozawa & Tetsuya Nishida

  6. Department of Hematology and Oncology, JA Aichi Konan Kosei Hospital, Konan, Japan

    Nobuaki Fukushima & Kazutaka Ozeki

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  1. Erina Takagi
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  2. Seitaro Terakura
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Contributions

ET, ST, AO, MM, and AT designed the study; ST, AO, KM, MS, TM, TG, YO, TN, NF, KO, RH, MM, and AT collected patient blood samples and clinical data; HF and KS measured anti-SARS-CoV-2 antibody titers; ET and ST performed statistical analysis; ET and ST generated figures and tables; ET, ST, AO, MM, AT, and HK wrote the paper. All the authors participated in discussions and interpretation of the data and results.

Corresponding author

Correspondence to Seitaro Terakura.

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Conflict of interest

H.F. and K.S. belong to an endowed department sponsored by FUJIFILIM Wako Pure Chemical Corporation. H.F. received a lecture fee from FUJIFILM Wako Pure Chemical Corporation. K.S. received research funding from FUJIFILM Wako Chemical Corporation. A.T. received research funding from Chugai Pharmaceutical, Astellas Pharma, Eisai, Otsuka Pharmaceutical, Ono Pharmaceutical, Kyowa Kirin, Shionogi, Sumitomo Dainippon Pharma, Taiho Pharmaceutical, Takeda Pharmaceutical, Teijin, Nippon Shinyaku, Nihon Pharmaceutical, Pfizer Japan, Mochida Pharmaceutical, Yakult Honsha, and Perseus Proteomics; and lecture fees from Chugai Pharmaceutical, Kyowa Kirin, Eisai, Takeda Pharmaceutical, Astellas Pharma, Nippon Shinyaku, Janssen Pharmaceutical, Zenyaku Kogyo, Abbvie GK, Bristol Myers Squibb, and SymBio Pharmaceutical. H. Kiyoi received research funding from FUJIFILM, Kyowa Kirin, Bristol Myers Squibb, Otsuka, Perseus Proteomics, Daiichi Sankyo, Abbvie, CURED, Astellas Pharma, Chugai, Zenyaku Kogyo, Nippon Shinyaku, Eisai, Takeda, Sumitomo Pharma, and Sanofi, and honoraria from Abbvie, Chugai, Astellas Pharma, and Novartis. The other authors declare no competing financial interests.

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Takagi, E., Terakura, S., Fujigaki, H. et al. Antibody response after third dose of COVID-19 mRNA vaccination in allogeneic hematopoietic stem cell transplant recipients is comparable to that in healthy counterparts. Int J Hematol 118, 462–471 (2023). https://doi.org/10.1007/s12185-023-03648-1

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  • DOI: https://doi.org/10.1007/s12185-023-03648-1

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