Journal for ImmunoTherapy of Cancer (Jul 2022)

T cell responses against SARS-CoV-2 and its Omicron variant in a patient with B cell lymphoma after multiple doses of a COVID-19 mRNA vaccine

  • Aaron P Rapoport,
  • Saurabh Dahiya,
  • Tim Luetkens,
  • Djordje Atanackovic,
  • Jeffrey Cohen,
  • John Baddley,
  • Nancy M Hardy,
  • Robert J Kreitman,
  • Destiny Omili,
  • Thierry Iraguha,
  • Peter D Burbelo,
  • Etse Gebru,
  • Xiaoxuan Fan

DOI
https://doi.org/10.1136/jitc-2022-004953
Journal volume & issue
Vol. 10, no. 7

Abstract

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Anti-SARS-CoV-2 antibodies are crucial for protection from future COVID-19 infections, limiting disease severity, and control of viral transmission. While patients with the most common type of hematologic malignancy, B cell lymphoma, often develop insufficient antibody responses to messenger RNA (mRNA) vaccines, vaccine-induced T cells would have the potential to ‘rescue’ protective immunity in patients with B cell lymphoma. Here we report the case of a patient with B cell lymphoma with profound B cell depletion after initial chemoimmunotherapy who received a total of six doses of a COVID-19 mRNA vaccine. The patient developed vaccine-induced anti-SARS-CoV-2 antibodies only after the fifth and sixth doses of the vaccine once his B cells had started to recover. Remarkably, even in the context of severe treatment-induced suppression of the humoral immune system, the patient was able to mount virus-specific CD4+ and CD8+ responses that were much stronger than what would be expected in healthy subjects after two to three doses of a COVID-19 mRNA vaccine and which were even able to target the Omicron ‘immune escape’ variant of the SARS-CoV-2 virus. These findings not only have important implications for anti-COVID-19 vaccination strategies but also for future antitumor vaccines in patients with cancer with profound treatment-induced immunosuppression.