{"doi":"10.1002/ajh.26322","title":"Serologic response to <scp>mRNA COVID</scp>‐19 vaccination in lymphoma patients","abstract":"To the Editor: The development of effective COVID-19 vaccines has been essential in slowing the spread of SARS-CoV-2. However, unvaccinated populations as well as those who do not respond to vaccination still remain at risk. Very few cancer patients were included in the COVID-19 mRNA vaccine trials and any individuals receiving chemotherapy or immunotherapy within 6 months were excluded.1 Consequently, we have an inadequate knowledge of how well these vaccines work in the cancer patient population. However, by extrapolation from other vaccines, we hypothesized that patients with hematologic malignancies, especially those on immunosuppressive therapy, would produce poor serological responses to a COVID-19 vaccine.2 In this single-center, observational cohort study we assessed antibody responses in lymphoma patients receiving a COVID-19 mRNA vaccine (BNT162b2, BioNTech/Pfizer, Germany/New York, NY; or mRNA-1273, Moderna, Cambridge, MA). All patients provided written informed consent to participate in observational research, and this study was approved by the Weill Cornell Medicine institutional review board (IRB 21-02023288). Serum samples were obtained before (when possible) and after vaccination. Post-vaccination samples were collected within 11–70 days of the second dose (median 24.5 days). In the healthcare worker (HCW) control group, the post-vaccination samples were obtained within 10–68 days of the second dose (median 40 days) (Figure S1). We also include data from a healthy control group of 35 HCWs enrolled in the NYP-WELCOME (WEilL COrnell Medicine Employees) observational trial (IRB 20-04021831). The use of this cohort in an mRNA vaccine study as well as the assay to quantify immunoglobulin G (IgG) antibodies to the SARS-CoV-2 S-protein has been described previously.3 Additionally, we determined whether any patients had serum antibodies to the SARS-CoV-2 nucleocapsid (N) protein, a marker for prior infection. The anti-S protein response to mRNA vaccination was assessed by enzyme-linked immunosorbent assay using sera from 67 patients with lymphoma and 35 healthy HCW controls. The majority of patients in this study were white (74.6%, Table S1). The median age of the study group was 71 (24–90). The most common comorbidities were hypertension (37.3%) and hyperlipidemia (50.7%). All patients were vaccinated with an mRNA vaccine (31 BNT162b2 and 36 mRNA-1273). The patients were categorized as having Hodgkin lymphoma (NHL; n = 4), chronic lymphocytic leukemia (CLL; n = 21), or other non-Hodgkin lymphomas (n = 42). Patients with other non-Hodgkin lymphomas included follicular lymphoma (7), marginal zone lymphoma (10), mantle cell lymphoma (8), diffuse large B-cell lymphoma (8), Waldenstrom macroglobulinemia (7), and other, unclassified lymphomas (2). No SARS-CoV-2 infections were identified during this study (February to April 2021). The vaccine-induced IgG antibody responses to the SARS-CoV-2 S-protein are shown in Figure 1(A). The median and mean endpoint titers in the HCW control group were higher than in the lymphoma patients, although the difference was not significant. There were also no significant differences in mean titers when patients with different lymphomas were compared. However, while all 35 healthy control group members responded to the vaccine, a substantial proportion of the lymphoma patients did not. Thus, the anti-S endpoint titers in nine of the 21 CLL patients and 17 of the 42 other NHL patients were <10 000 (a cut-off level marked on Figure 1), and were often undetectable. By contrast, the four Hodgkin lymphoma patients all responded to the vaccines. When the data were grouped according to whether the participants received the BNT162b2 or mRNA-1273 vaccine, no differences were apparent. In total, eight lymphoma patients were anti-N-positive while all members of the HCW control group were anti-N-negative. For four of the eight anti-N-positive lymphoma patients, there was evidence of COVID-19 prior to the ","journal":"American Journal of Hematology","year":2021,"id":171059,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":27,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9573,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":253814,"name":"Thomas J. Ketas","orcid":"0000-0001-9380-7716","position":1,"is_corresponding":false},{"id":561975,"name":"Zhen Zhao","orcid":"0000-0002-9742-5982","position":2,"is_corresponding":false},{"id":228355,"name":"Michael J. Satlin","orcid":"0000-0003-4711-5334","position":3,"is_corresponding":false},{"id":659768,"name":"Catherine B. Small","orcid":"0000-0002-0601-6615","position":4,"is_corresponding":false},{"id":622289,"name":"Ashley Sukhu","orcid":null,"position":5,"is_corresponding":false},{"id":562540,"name":"Erik Francomano","orcid":null,"position":6,"is_corresponding":false},{"id":249513,"name":"Per Johan Klasse","orcid":"0000-0001-8222-278X","position":7,"is_corresponding":false},{"id":705652,"name":"A. Alberto González García","orcid":null,"position":8,"is_corresponding":false},{"id":705653,"name":"Emeline Nguyenduy","orcid":null,"position":9,"is_corresponding":false},{"id":234684,"name":"Erica B. Bhavsar","orcid":null,"position":10,"is_corresponding":false},{"id":259685,"name":"Silvia C. Formenti","orcid":"0000-0002-8227-8924","position":11,"is_corresponding":false},{"id":233553,"name":"Richard R. Furman","orcid":"0000-0003-1677-7626","position":12,"is_corresponding":false},{"id":249512,"name":"John P. Moore","orcid":"0000-0002-9902-6096","position":13,"is_corresponding":false},{"id":285253,"name":"John P. Leonard","orcid":"0000-0002-5083-1115","position":14,"is_corresponding":false},{"id":574842,"name":"Peter Martin","orcid":"0000-0001-7813-1551","position":15,"is_corresponding":false},{"id":704838,"name":"Eric M. Jurgens","orcid":"0000-0001-8280-2581","position":0,"is_corresponding":true}],"reference_count":6,"raw_metadata":null,"created_at":"2026-07-18T23:46:28.747384Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}