TY - JOUR
T1 - Immunogenicity of the 13-Valent Pneumococcal Conjugated Vaccine Followed by the 23-Valent Polysaccharide Vaccine in Chronic Lymphocytic Leukemia
AU - Haggenburg, Sabine
AU - Garcia Garrido, Hannah M.
AU - Kant, Iris M. J.
AU - van der Straaten, Hanneke M.
AU - de Boer, Fransien
AU - Kersting, Sabina
AU - Issa, Djamila
AU - te Raa, Doreen
AU - Visser, Hein P. J.
AU - Kater, Arnon P.
AU - Goorhuis, Abraham
AU - de Heer, Koen
N1 - Funding Information: This work was supported by a public research grant of The Netherlands Organisation for Health Research and Development (ZonMw), grant number 522004005. The funder of the study had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study. Publisher Copyright: © 2023 by the authors.
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Patients with Chronic Lymphocytic Leukemia (CLL) have a 29- to 36-fold increased risk of invasive pneumococcal disease (IPD) compared to healthy adults. Therefore, most guidelines recommend vaccination with the 13-valent pneumococcal conjugated vaccine (PCV13) followed 2 months later by the 23-valent polysaccharide vaccine (PPSV23). Because both CLL as well as immunosuppressive treatment have been identified as major determinants of immunogenicity, we aimed to assess the vaccination schedule in untreated and treated CLL patients. We quantified pneumococcal IgG concentrations against five serotypes shared across both vaccines, and against four serotypes unique to PPSV23, before and eight weeks after vaccination. In this retrospective cohort study, we included 143 CLL patients, either treated (n = 38) or naive to treatment (n = 105). While antibody concentrations increased significantly after vaccination, the overall serologic response was low (10.5%), defined as a ≥4-fold antibody increase against ≥70% of the measured serotypes, and significantly influenced by treatment status and prior lymphocyte number. The serologic protection rate, defined as an antibody concentration of ≥1.3 µg/mL for ≥70% of serotypes, was 13% in untreated and 3% in treated CLL patients. Future research should focus on vaccine regimens with a higher immunogenic potential, such as multi-dose schedules with higher-valent T cell dependent conjugated vaccines.
AB - Patients with Chronic Lymphocytic Leukemia (CLL) have a 29- to 36-fold increased risk of invasive pneumococcal disease (IPD) compared to healthy adults. Therefore, most guidelines recommend vaccination with the 13-valent pneumococcal conjugated vaccine (PCV13) followed 2 months later by the 23-valent polysaccharide vaccine (PPSV23). Because both CLL as well as immunosuppressive treatment have been identified as major determinants of immunogenicity, we aimed to assess the vaccination schedule in untreated and treated CLL patients. We quantified pneumococcal IgG concentrations against five serotypes shared across both vaccines, and against four serotypes unique to PPSV23, before and eight weeks after vaccination. In this retrospective cohort study, we included 143 CLL patients, either treated (n = 38) or naive to treatment (n = 105). While antibody concentrations increased significantly after vaccination, the overall serologic response was low (10.5%), defined as a ≥4-fold antibody increase against ≥70% of the measured serotypes, and significantly influenced by treatment status and prior lymphocyte number. The serologic protection rate, defined as an antibody concentration of ≥1.3 µg/mL for ≥70% of serotypes, was 13% in untreated and 3% in treated CLL patients. Future research should focus on vaccine regimens with a higher immunogenic potential, such as multi-dose schedules with higher-valent T cell dependent conjugated vaccines.
KW - antibody response
KW - chronic lymphocytic leukemia
KW - immunogenicity
KW - pneumococcal vaccination
UR - http://www.scopus.com/inward/record.url?scp=85169189380&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/vaccines11071201
DO - https://doi.org/10.3390/vaccines11071201
M3 - Article
C2 - 37515017
SN - 2076-393X
VL - 11
JO - Vaccines
JF - Vaccines
IS - 7
M1 - 1201
ER -