{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T19:30:00Z","timestamp":1777577400881,"version":"3.51.4"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T00:00:00Z","timestamp":1641340800000},"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":["Br J Haematol"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Chronic lymphocytic leukaemia (CLL) is associated with immunocompromise and high risk of severe COVID\u201019 disease and mortality. Monoclonal B\u2010cell lymphocytosis (MBL) patients also have immune impairment. We evaluated humoural and cellular immune responses in 181 patients with CLL (160) and MBL (21) to correlate failed seroconversion [&lt;50\u00a0AU\/ml SARS\u2010CoV\u20102 II IgG assay, antibody to spike protein; Abbott Diagnostics)] following each of two vaccine doses with clinical and laboratory parameters. Following first and second doses, 79.2% then 45% of CLL, and 50% then 9.5% of MBL patients respectively remained seronegative. There was significant association between post dose two antibody level with pre\u2010vaccination reduced IgM (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a00.0001), IgG2 (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a00.035), and IgG3 (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a00.046), and CLL therapy within 12\u00a0months (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a00.001) in univariate analysis. By multivariate analysis, reduced IgM (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a00.0002) and active therapy (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a00.0002) retained significance. Anti\u2010spike protein levels varied widely and were lower in CLL than MBL patients, and both lower than in normal donors. Neutralisation activity showed anti\u2010spike levels &lt;1000\u00a0AU\/ml were usually negative for both an early viral clade and the contemporary Delta variant and 72.9% of CLL and 53.3% of MBL failed to reach levels \u22651000\u00a0AU\/ml. In a representative sample, ~80% had normal T\u2010cell responses. Failed seroconversion occurred in 36.6% of treatment\u2010na\u00efve patients, in 78.1% on therapy, and in 85.7% on ibrutinib.\n                  <\/jats:p>","DOI":"10.1111\/bjh.18014","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T09:36:12Z","timestamp":1640684172000},"page":"41-51","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["COVID\u201019 vaccine failure in chronic lymphocytic leukaemia and monoclonal B\u2010lymphocytosis; humoural and cellular immunity"],"prefix":"10.1111","volume":"197","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1344-5143","authenticated-orcid":false,"given":"Yandong","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Haematology Royal North Shore Hospital  St Leonards, Sydney New South Wales Australia"},{"name":"Kolling Institute Royal North Shore Hospital  St Leonards, Sydney New South Wales 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Hospital  St Leonards, Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucinda","family":"Wallman","sequence":"additional","affiliation":[{"name":"Department of Immunology Laverty Pathology  Macquarie Park, Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nenna","family":"Van Bilsen","sequence":"additional","affiliation":[{"name":"Department of Haematology and Flow Cytometry Laverty Pathology  Macquarie Park, Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Milogiannakis","sequence":"additional","affiliation":[{"name":"Kirby Institute University of New South Wales  Kensington, Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anouschka","family":"Akerman","sequence":"additional","affiliation":[{"name":"Kirby Institute University of New South Wales  Kensington, Sydney New 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