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Published on: June 12, 2021
CD8+ T cells contribute to survival in patients with COVID-19 and hematologic cancer
Erin M Bange1,2, Nicholas A Han1,3, Paul Wileyto2,4
1Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Insights
Patients with hematologic cancer experiencing COVID-19 have higher mortality due to impaired B cell and antibody responses. However, increased CD8 T cells correlate with improved survival, suggesting their importance in recovery.
Area of Science:
- Immunology
- Oncology
- Infectious Diseases
Background:
- Patients with cancer face elevated mortality from coronavirus disease 2019 (COVID-19).
- Immune parameters influencing COVID-19 outcomes in cancer patients are not fully understood.
- Hematologic cancer patients exhibit higher mortality compared to solid cancer patients hospitalized with COVID-19.
Purpose of the Study:
- To investigate immune phenotypes and their correlation with clinical outcomes in cancer patients hospitalized with COVID-19.
- To identify immune parameters associated with survival in COVID-19 patients with hematologic malignancies.
Main Methods:
- Analysis of immune cell populations and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific antibody responses using flow cytometry and serologic assays.
- Comparison of immune profiles between patients with solid cancer, hematologic cancer, and those without cancer.
- Correlation of CD8 T cell counts with survival rates in COVID-19 patients with hematologic cancer.
Main Results:
- Patients with hematologic cancer showed impaired B cell function and SARS-CoV-2-specific antibody responses compared to solid cancer patients and non-cancer controls.
- Despite impaired humoral immunity, a higher number of CD8 T cells was associated with improved survival in hematologic cancer patients with COVID-19.
- A significant proportion (77%) of hematologic cancer patients exhibited detectable SARS-CoV-2-specific T cell responses.
Conclusions:
- CD8 T cells may play a crucial role in recovery from COVID-19, particularly in patients with hematologic cancer experiencing deficient humoral immunity.
- T cell responses could be vital for protection against COVID-19 in hematologic cancer patients, even with suboptimal antibody responses.
- Findings suggest that CD8 T cell responses to vaccination may offer protection in this vulnerable patient population.
Abstract:
Patients with cancer have high mortality from coronavirus disease 2019 (COVID-19), and the immune parameters that dictate clinical outcomes remain unknown. In a cohort of 100 patients with cancer who were hospitalized for COVID-19, patients with hematologic cancer had higher mortality relative to patients with solid cancer. In two additional cohorts, flow cytometric and serologic analyses demonstrated that patients with solid cancer and patients without cancer had a similar immune phenotype during acute COVID-19, whereas patients with hematologic cancer had impairment of B cells and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific antibody responses. Despite the impaired humoral immunity and high mortality in patients with hematologic cancer who also have COVID-19, those with a greater number of CD8 T cells had improved survival, including those treated with anti-CD20 therapy. Furthermore, 77% of patients with hematologic cancer had detectable SARS-CoV-2-specific T cell responses. Thus, CD8 T cells might influence recovery from COVID-19 when humoral immunity is deficient. These observations suggest that CD8 T cell responses to vaccination might provide protection in patients with hematologic cancer even in the setting of limited humoral responses.
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