{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:13:38Z","timestamp":1788315218151,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T00:00:00Z","timestamp":1636070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Monoclonal B\u2010cell lymphocytosis (MBL) and chronic lymphocytic leukemia (CLL) are clonal B\u2010cell disorders associated with an increased risk of infections and impaired vaccination responses. We investigated the immunogenicity of recombinant zoster vaccine (RZV) in these patients. Individuals with MBL\/untreated CLL and Bruton tyrosine kinase inhibitor (BTKi)\u2010treated CLL patients were given two doses of RZV separated by 2\u2009months. Responses assessed at 3 and 12\u2009months from the first dose of RZV by an anti\u2010glycoprotein E ELISA antibody assay and by dual\u2010color Interferon\u2010\u03b3 and Interleukin\u20102FLUOROSPOT assays were compared to historic controls matched by age and sex. About 62 patients (37 MBL\/untreated CLL and 25 BTKi\u2010treated CLL) were enrolled with a median age of 68\u2009years at vaccination. An antibody response at 3\u2009months was seen in 45% of participants, which was significantly lower compared to historic controls (63%, <jats:italic>p<\/jats:italic>\u00a0=\u2009.03). The antibody response did not significantly differ between MBL\/untreated CLL and BTKi\u2010treated CLL (51% vs. 36%, respectively, <jats:italic>p<\/jats:italic>\u00a0=\u2009.23). The CD4+ T\u2010cell response to vaccination was significantly lower in study participants compared to controls (54% vs. 96%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.001), mainly due to lower responses among BTKi\u2010treated patients compared to untreated MBL\/CLL (32% vs. 73%, <jats:italic>p<\/jats:italic>\u00a0=\u2009.008). Overall, only 29% of participants achieved combined antibody and cellular responses to RZV. Among participants with response assessment at 12\u2009months (<jats:italic>n<\/jats:italic>\u00a0=\u200947), 24% had antibody titers below the response threshold. Hypogammaglobulinemia and BTKi therapy were associated with reduced T\u2010cell responses in a univariate analysis. Strategies to improve vaccine response to RZV among MBL\/CLL patients are needed.<\/jats:p>","DOI":"10.1002\/ajh.26388","type":"journal-article","created":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T17:07:35Z","timestamp":1635268055000},"page":"90-98","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Humoral and cellular immune responses to recombinant herpes zoster vaccine in patients with chronic lymphocytic leukemia and monoclonal B cell lymphocytosis"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2210-2174","authenticated-orcid":false,"given":"Eli","family":"Muchtar","sequence":"first","affiliation":[{"name":"Division of Hematology, Department of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2539-040X","authenticated-orcid":false,"given":"Amber B.","family":"Koehler","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (Infectious Diseases) University of Colorado Anschutz Medical Campus  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7313-1875","authenticated-orcid":false,"given":"Kari G.","family":"Rabe","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9811-4601","authenticated-orcid":false,"given":"Wei","family":"Ding","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy G.","family":"Call","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose F.","family":"Leis","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology Mayo Clinic  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2767-3830","authenticated-orcid":false,"given":"Saad S.","family":"Kenderian","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne R.","family":"Hayman","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1576-8341","authenticated-orcid":false,"given":"Yucai","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1292-3024","authenticated-orcid":false,"given":"Paul J.","family":"Hampel","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A.","family":"Holets","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather C.","family":"Darby","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L.","family":"Slager","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Quantitative Health Sciences Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil E.","family":"Kay","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Congrong","family":"Miao","sequence":"additional","affiliation":[{"name":"National VZV Laboratory Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Canniff","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (Infectious Diseases) University of Colorado Anschutz Medical Campus  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A.","family":"Whitaker","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myron J.","family":"Levin","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics (Infectious Diseases) and Medicine (Infectious Diseases) University of Colorado Anschutz Medical Campus  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Scott","family":"Schmid","sequence":"additional","affiliation":[{"name":"National VZV Laboratory Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard B.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Vaccine Research Group, Division of General Internal Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (Infectious Diseases), Medicine (Infectious Diseases), and Pathology University of Colorado Anschutz Medical Campus  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3221-7314","authenticated-orcid":false,"given":"Sameer A.","family":"Parikh","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2005.0150.x"},{"key":"e_1_2_8_3_1","unstructured":"Centers for Disease Control and Prevention.Shingles (herpes zoster). Accessed June 4 2021.https:\/\/www.cdc.gov\/shingles\/hcp\/clinical-overview.html"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21654"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-09-806398"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminoncol.2005.12.013"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61381-5"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-02-140582"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2016.1267352"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-17-3761"},{"key":"e_1_2_8_11_1","first-page":"1","article-title":"Advisory committee on immunization practices centers for disease C, prevention. Prevention of herpes zoster: recommendations of the advisory committee on immunization practices (ACIP)","volume":"57","author":"Harpaz R","year":"2008","journal-title":"MMWR Recomm Rep"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiy095"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1603800"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-04-573048"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiu606"},{"key":"e_1_2_8_16_1","first-page":"181","article-title":"Immunogenicity and safety of the Adjuvanted recombinant zoster vaccine in chronically immunosuppressed adults following renal transplant: a phase 3. Randomized clinical trial","volume":"70","author":"Vink P","year":"2020","journal-title":"Clin Infect Dis"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31909"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.9053"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(19)30163-X"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-020-01074-4"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020008758"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2009.287"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-020-0799-8"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2012.187"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2018.03.004"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.00240-21"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-020-01074-4"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI121484"},{"key":"e_1_2_8_29_1","volume-title":"Corerlates of Protection","author":"Levin MJ","year":"2017"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.612244"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-02-411678"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.00305-19"},{"key":"e_1_2_8_33_1","first-page":"2427","article-title":"Chronic lymphocytic leukemia T cells show impaired immunological synapse formation that can be reversed with an immunomodulating drug","volume":"118","author":"Ramsay AG","year":"2008","journal-title":"J Clin Invest"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-09-457531"},{"key":"e_1_2_8_35_1","unstructured":"ParikhSA RA BoysenJ LesnickC DingW MedinaK IonnaouN JelinekDF SlagerSL KayNE ShanafeltTD.Longitudinal evaluation of T\u2010cells in clinical monoclonal B\u2010cell lymphocytosis (MBL). 21st Annual Congress of European Haematology Association;2016; Copenhagen Denmark: Haematologica."},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI89756"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1601190"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-06-507947"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-020-0873-2"},{"key":"e_1_2_8_40_1","first-page":"440","article-title":"Room for improvement: immunizations for patients with monoclonal B\u2010cell lymphocytosis or chronic lymphocytic leukemia","volume":"12","author":"Whitaker JA","year":"2014","journal-title":"Clin Adv Hematol Oncol"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2021.01.001"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021011568"},{"key":"e_1_2_8_43_1","first-page":"1902","article-title":"Improved vaccination response during ranitidine treatment, and increased plasma histamine concentrations, in patients with B cell chronic lymphocytic leukemia","volume":"9","author":"Jurlander J","year":"1995","journal-title":"Leukemia"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23561"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-11-1221"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1315727"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(17)30235-7"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2108861"}],"container-title":["American Journal of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.26388","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ajh.26388","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.26388","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T02:32:51Z","timestamp":1693103571000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,5]]},"references-count":47,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1002\/ajh.26388"],"URL":"https:\/\/doi.org\/10.1002\/ajh.26388","archive":["Portico"],"relation":{},"ISSN":["0361-8609","1096-8652"],"issn-type":[{"value":"0361-8609","type":"print"},{"value":"1096-8652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,5]]},"assertion":[{"value":"2021-09-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}