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

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

Authors:	Einarsdottir, S.; Lobaugh, S.; Luan, D.; Gomez-Llobell, M.; Subramanian, P.; Devlin, S.; Chung, D.; Dahi, P. B.; Falchi, L.; Giralt, S.; Landau, H.; Lesokhin, A. M.; Lin, R.; Lue, J.; Mailankody, S.; Palomba, M. L.; Park, J. H.; Salles, G.; Scordo, M.; Escribano-Serrat, S.; Sanz, J.; Rejeski, K.; Shouval, R.; Usmani, S.; Perales, M. A.; Shah, G.; Shahid, Z.
Article Title:	Humoral vaccine responses following Chimeric Antigen Receptor T-cell therapy for hematological malignancies
Abstract:	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. © The Author(s) 2025.
Keywords:	adult; aged; aged, 80 and over; middle aged; retrospective studies; young adult; major clinical study; fludarabine; clinical feature; hepatitis b; cohort analysis; bendamustine; cyclophosphamide; retrospective study; b lymphocyte; immunology; hematologic malignancy; hematologic neoplasms; vaccination; chimeric antigen receptor; cell count; humoral immunity; haemophilus influenzae type b; pneumococcal infection; therapy; adoptive immunotherapy; immunotherapy, adoptive; hematologic disease; pertussis; diphtheria; tetanus; immune reconstitution; immunity, humoral; demographics; procedures; poliomyelitis; very elderly; humans; human; male; female; article; hepatitis a; chimeric antigen receptor t-cell immunotherapy; receptors, chimeric antigen
Journal Title:	Blood Cancer Journal
Volume:	15
ISSN:	2044-5385
Publisher:	Nature Publishing Group
Date Published:	2025-07-02
Start Page:	114
Language:	English
DOI:	10.1038/s41408-025-01321-w
PUBMED:	40603286
PROVIDER:	scopus
PMCID:	PMC12223166
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-105010028186&doi=10.1038%2fs41408-025-01321-w&partnerID=40&md5=afb028ce99867dac7288034cc909efd3
Notes:	Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Zainab Shahid -- Source: Scopus