Researchers say they have identified biomarkers associated with poor antibody response to COVID-19 vaccination in patients with hematologic malignancies. 

Two treatment-related factors and the frequency of 6 cell types — neutrophils, classical monocytes, CD4 and CD8 effector memory CD127low T cells, and naïve CD21+ and IgM+ IgD+ memory B cells — were associated with response to COVID-19 vaccination.

These biomarkers may help guide the use of vaccine boosters in patients with hematologic malignancies, according to researchers. The team reported their findings in a poster at the EHA 2022 Hybrid Congress.

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With their study, the researchers aimed to determine if immune profiling prior to vaccination might show a relationship with antibody response after 2 doses of a COVID-19 vaccine.

The researchers analyzed peripheral blood and serum samples from patients with mature B-cell and plasma-cell neoplasms, in addition to age-matched health care professionals (HCPs) for comparison. 

A total of 83 patients with hematologic malignancies and 102 HCPs were included in the analysis. The patients had indolent non-Hodgkin lymphoma (n=25), multiple myeloma (n=25), aggressive non-Hodgkin lymphoma (n=16), Hodgkin lymphoma (n=7), chronic lymphocytic leukemia (n=7), smoldering myeloma (n=2), and monoclonal gammopathy of undetermined significance (n=1).

The patients had significantly worse responses to a second vaccine dose compared with HCPs. The median anti-receptor binding domain (RBD) IgG titer after the second vaccine dose was 553 IU/mL in patients and 6014 IU/mL in HCPs (P <.001). 

Further analysis revealed the 2 treatment-related factors and 6 cell types associated with a worse antibody response to vaccination among the patients. 

Having received no prior anticancer therapy and an increased frequency of both naïve CD21+ and IgM+ IgD+ memory B cells were associated with a better response to vaccination (≥553.5 IU/mL anti-RBD IgG).

On the other hand, prior exposure to anti-CD38 therapy and the expansion of neutrophils, classical monocytes, and CD4 and CD8 effector memory CD127low T cells were associated with worse antibody response to vaccination (<553.5 IU/mL anti-RBD IgG).


Tamariz-Amador LE, Battaglia AM, Maia C, et al. Immune biomarkers to predict SARS-CoV-2 vaccine effectiveness in patients with hematological malignancies. Presented at EHA 2022; June 9-12, 2022. Abstract P1593.