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Updated: Aug 16, 2025
Generation of Multivirus-specific T Cells to Prevent/treat Viral Infections after Allogeneic Hematopoietic Stem Cell Transplant
Published on: May 27, 2011
Immunogenicity of SARS-CoV-2 vaccination in patients undergoing autologous stem cell transplantation. A multicentric
Francesco Autore1, Luca Stirparo2, Idanna Innocenti1
1Dipartimento di Diagnostica per Immagini Radioterapia Oncologica ed Ematologia Fondazione Policlinico, Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.
Insights
Hematopoietic stem cell transplant patients have variable COVID-19 vaccine responses. Rituximab treatment significantly lowers immunization rates, while the transplant procedure itself has minimal impact.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- COVID-19 poses significant risks to hematological patients, especially those undergoing autologous hematopoietic stem cell transplantation (aHSCT).
- Vaccine effectiveness in this vulnerable population is highly variable.
- Previous studies indicate rituximab treatment reduces SARS-CoV-2 immunization rates.
Purpose of the Study:
- To evaluate the serological response to SARS-CoV-2 vaccination in patients who underwent aHSCT.
- To identify factors influencing vaccine effectiveness post-transplantation.
Main Methods:
- Multicenter retrospective observational study.
- Inclusion of 82 patients who underwent aHSCT, divided into two groups: vaccinated post-aHSCT (n=58) and pre-aHSCT (n=24).
- Serological assessment for SARS-CoV-2 antibodies.
Main Results:
- Overall, 67% of patients vaccinated post-aHSCT showed positive serology, increasing with time.
- Rituximab administration, especially within 6 months of vaccination, predicted negative serology in non-Hodgkin lymphoma patients (13% response rate).
- Patients with plasma cell disorders had a high positive serology rate (83%).
- aHSCT did not negatively impact pre-transplantation vaccination response.
Conclusions:
- Rituximab is a significant negative predictor of SARS-CoV-2 vaccine response in aHSCT patients.
- The conditioning and transplantation procedure itself appears less critical than rituximab's effect.
- Vaccination timing and underlying hematological condition influence immune response.
Abstract:
COVID-19 disease has a strong impact on hematological patients; those receiving autologous hematopoietic stem cell transplantation (aHSCT) represent a particularly vulnerable group, in which the effectiveness of vaccination is very variable. Chiarucci et al. showed that patients affected by non-Hodgkin lymphoma (NHL) and treated with rituximab experienced a lower rate of immunization against SARS-CoV-2 (54%), as well as significantly lower IgG antibody titers. In our multicenter retrospective observational study, we included 82 patients who underwent aHSCT, divided into two groups: 58 patients vaccinated after aHSCT (group A) and 24 vaccinated before getting transplantation (group B). In group A, 39 (67%) patients had positive serology, and the rate of positivity increased with time after aHSCT. In the subgroup of patients with NHL, the administration of rituximab predicted negative serology, particularly when administered in the 6 months before vaccination (13% response rate). Patients affected by plasma cells had a higher rate of positivity (83% overall), independently of the time to aHSCT. In group B, no patient who initially showed positive serology became negative after transplantation, so the aHSCT did not affect the response to the vaccination. Our study confirmed the role of rituximab as a negative predictor of response to SARS-CoV-2 vaccination, whereas the conditioning and transplantation procedure itself seemed to be less important.
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