Humoral and cellular immune responses to recombinant herpes zoster vaccine in patients with chronic lymphocytic leukemia and monoclonal B cell lymphocytosis

Eli Muchtar, Amber B. Koehler, Michael J. Johnson, Kari G. Rabe, Wei D Ding, Timothy George Call, Jose F. Leis, Saad S. Kenderian, Suzanne R. Hayman, Yucai Wang, Paul J. Hampel, Matthew A. Holets, Heather C. Darby, Susan L. Slager, Neil Elliot Kay, Congrong Miao, Jennifer Canniff, Jennifer A Whitaker, Myron J. Levin, D. Scott SchmidRichard B Kennedy, Adriana Weinberg, Sameer A. Parikh

Research output: Contribution to journalArticlepeer-review

Abstract

Monoclonal B-cell lymphocytosis (MBL) and chronic lymphocytic leukemia (CLL) are clonal B-cell disorders associated with an increased risk of infections and impaired vaccination responses. We investigated the immunogenicity of recombinant zoster vaccine (RZV) in these patients. Individuals with MBL/untreated CLL and Bruton tyrosine kinase inhibitor (BTKi)-treated CLL patients were given two doses of RZV separated by 2 months. Responses assessed at 3 and 12 months from the first dose of RZV by an anti-glycoprotein E ELISA antibody assay and by dual-color Interferon-γ and Interleukin-2FLUOROSPOT assays were compared to historic controls matched by age and sex. About 62 patients (37 MBL/untreated CLL and 25 BTKi-treated CLL) were enrolled with a median age of 68 years at vaccination. An antibody response at 3 months was seen in 45% of participants, which was significantly lower compared to historic controls (63%, p =.03). The antibody response did not significantly differ between MBL/untreated CLL and BTKi-treated CLL (51% vs. 36%, respectively, p =.23). The CD4+ T-cell response to vaccination was significantly lower in study participants compared to controls (54% vs. 96%, p <.001), mainly due to lower responses among BTKi-treated patients compared to untreated MBL/CLL (32% vs. 73%, p =.008). Overall, only 29% of participants achieved combined antibody and cellular responses to RZV. Among participants with response assessment at 12 months (n = 47), 24% had antibody titers below the response threshold. Hypogammaglobulinemia and BTKi therapy were associated with reduced T-cell responses in a univariate analysis. Strategies to improve vaccine response to RZV among MBL/CLL patients are needed.

Original languageEnglish (US)
JournalAmerican journal of hematology
DOIs
StateAccepted/In press - 2021

ASJC Scopus subject areas

  • Hematology

Fingerprint

Dive into the research topics of 'Humoral and cellular immune responses to recombinant herpes zoster vaccine in patients with chronic lymphocytic leukemia and monoclonal B cell lymphocytosis'. Together they form a unique fingerprint.

Cite this