Prospective comprehensive profiling of immune responses to COVID-19 vaccination in patients on zanubrutinib therapy

Thi H O Nguyen; Chhay Lim; Masa Lasica; Ashley Whitechurch; Surekha Tennakoon; Natalie R Saunders; Lilith F Allen; Louise C Rowntree; Brendon Y Chua; Lukasz Kedzierski; Hyon-Xhi Tan; Adam K Wheatley; Stephen J Kent; Theo Karapanagiotidis; Suellen Nicholson; Deborah A Williamson; Monica A Slavin; Constantine S Tam; Katherine Kedzierska; Benjamin W Teh

doi:10.1002/jha2.639

Prospective comprehensive profiling of immune responses to COVID-19 vaccination in patients on zanubrutinib therapy

EJHaem. 2023 Jan 20;4(1):216-220. doi: 10.1002/jha2.639. eCollection 2023 Feb.

Authors

Thi H O Nguyen¹, Chhay Lim², Masa Lasica³, Ashley Whitechurch⁴, Surekha Tennakoon², Natalie R Saunders², Lilith F Allen¹, Louise C Rowntree¹, Brendon Y Chua¹, Lukasz Kedzierski¹, Hyon-Xhi Tan¹, Adam K Wheatley¹, Stephen J Kent^{1

5

6}, Theo Karapanagiotidis⁷, Suellen Nicholson⁷, Deborah A Williamson^{7

8

9}, Monica A Slavin^{2

10}, Constantine S Tam^{4

11}, Katherine Kedzierska¹, Benjamin W Teh^{2

10}

Affiliations

¹ Department of Microbiology and Immunology University of Melbourne Parkville Victoria Australia.
² Department of Infectious Diseases Peter MacCallum Cancer Centre Melbourne Victoria Australia.
³ Department of Haematology St Vincent's Hospital Fitzroy Victoria Australia.
⁴ Department of Clinical Haematology Peter MacCallum Cancer Centre and Royal Melbourne Hospital Melbourne Victoria Australia.
⁵ ARC Centre of Excellence in Convergent Bio-Nano Science and Technology University of Melbourne Melbourne Victoria Australia.
⁶ Melbourne Sexual Health Centre, Infectious Diseases Department, Alfred Health, Central Clinical School Monash University Melbourne Victoria Australia.
⁷ Victorian Infectious Diseases Reference Laboratory The Peter Doherty Institute for Infection and Immunity Melbourne Victoria Australia.
⁸ Walter and Eliza Hall Institute of Medical Research Parkville Victoria Australia.
⁹ Department of Infectious Diseases University of Melbourne, The Peter Doherty Institute for Infection and Immunity Melbourne Victoria Australia.
¹⁰ Sir Peter MacCallum Department of Oncology University of Melbourne Parkville Victoria Australia.
¹¹ Department of Haematology, Alfred Hospital Monash University Melbourne Victoria Australia.

Abstract

Zanubrutinib-treated and treatment-naïve patients with chronic lymphocytic leukaemia (CLL) or Waldenstrom's macroglobulinaemia were recruited in this prospective study to comprehensively profile humoral and cellular immune responses to COVID-19 vaccination. Overall, 45 patients (median 72 years old) were recruited; the majority were male (71%), had CLL (76%) and were on zanubrutinib (78%). Seroconversion rates were 65% and 77% following two and three doses, respectively. CD4⁺ and CD8⁺ T-cell response rates increased with third dose. In zanubrutinib-treated patients, 86% developed either a humoral or cellular response. Patients on zanubrutinib developed substantial immune responses following two COVID-19 vaccine doses, which further improved following a third dose.

Keywords: SARS‐CoV‐2; response; vaccination; zanubrutinib.