Anti-SARS-CoV-2 Immune Responses in Patients Receiving an Allogeneic Stem Cell or Organ Transplant
Djordje Atanackovic,
Tim Luetkens,
Stephanie V. Avila,
Nancy M. Hardy,
Forat Lutfi,
Gabriela Sanchez-Petitto,
Erica Vander Mause,
Nicole Glynn,
Heather D. Mannuel,
Hanan Alkhaldi,
Kim Hankey,
John Baddley,
Saurabh Dahiya,
Aaron P. Rapoport
Affiliations
Djordje Atanackovic
Transplant and Cellular Therapy Program, Department of Medicine, University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA
Tim Luetkens
Transplant and Cellular Therapy Program, Department of Medicine, University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA
Stephanie V. Avila
Transplant and Cellular Therapy Program, Department of Medicine, University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA
Nancy M. Hardy
Transplant and Cellular Therapy Program, Department of Medicine, University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA
Forat Lutfi
University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA
Gabriela Sanchez-Petitto
University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA
Erica Vander Mause
Transplant and Cellular Therapy Program, Department of Medicine, University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA
Nicole Glynn
Transplant and Cellular Therapy Program, Department of Medicine, University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA
Heather D. Mannuel
Hematology/Oncology, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA
Hanan Alkhaldi
University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA
Kim Hankey
Transplant and Cellular Therapy Program, Department of Medicine, University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA
John Baddley
Division of Infectious Diseases, University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA
Saurabh Dahiya
Transplant and Cellular Therapy Program, Department of Medicine, University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA
Aaron P. Rapoport
Transplant and Cellular Therapy Program, Department of Medicine, University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA
Patients after autologous (autoSCT) and allogeneic stem cell transplantation (alloSCT) are at an increased risk of COVID-19-related morbidity and mortality, compounded by an immune system weakened by the underlying malignancy and prior treatments. Allogeneic transplantation, including stem cell and solid organ transplants, requires intensive immunosuppressive prophylaxis, which may further undermine the development of a protective vaccine-induced anti-viral immunity. Herein, we report on short- and long-term antiviral immune responses in two peri-stem cell transplant recipients and a third patient who received a COVID-19 vaccination after kidney transplantation. Our data indicate that: (1) patients post-alloSCT may be able to mount an anti-COVID-19 immune response; however, a sufficient time interval between transplant and exposure may be of critical importance; (2) alloSCT recipients with preexisting anti-SARS-CoV-2 immunity are at risk for losing protective humoral immunity following transplantation, particularly if the stem-cell donor lacks antiviral immunity, e.g., vaccine-derived immunity; and (3) some post-transplant patients are completely unable to build an immune response to a COVID-19 vaccine, perhaps based on the prophylactic suppression of T cell immunity.
