{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:35:56Z","timestamp":1793414156849,"version":"4.5.0"},"reference-count":42,"publisher":"American Society of Hematology","issue":"26","license":[{"start":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T00:00:00Z","timestamp":1663632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,12,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Limited data are available on breakthrough COVID-19 in patients with hematologic malignancy (HM) after anti\u2013severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. Adult patients with HM, \u22651 dose of anti-SARS-CoV-2 vaccine, and breakthrough COVID-19 between January 2021 and March 2022 were analyzed. A total of 1548 cases were included, mainly lymphoid malignancies (1181 cases, 76%). After viral sequencing in 753 cases (49%), the Omicron variant was prevalent (517, 68.7%). Most of the patients received \u22642 vaccine doses before COVID-19 (1419, 91%), mostly mRNA-based (1377, 89%). Overall, 906 patients (59%) received COVID-19-specific treatment. After 30-day follow-up from COVID-19 diagnosis, 143 patients (9%) died. The mortality rate in patients with the Omicron variant was 7.9%, comparable to other variants, with a significantly lower 30-day mortality rate than in the prevaccine era (31%). In the univariable analysis, older age (P\u00a0&amp;lt; .001), active HM (P\u00a0&amp;lt; .001), and severe and critical COVID-19 (P\u00a0= .007 and\u00a0P\u00a0&amp;lt; .001, respectively) were associated with mortality. Conversely, patients receiving monoclonal antibodies, even for severe or critical COVID-19, had a lower mortality rate (P\u00a0&amp;lt; .001). In the multivariable model, older age, active disease, critical COVID-19, and 2-3 comorbidities were correlated with a higher mortality, whereas monoclonal antibody administration, alone (P\u00a0&amp;lt; .001) or combined with antivirals (P\u00a0= .009), was protective. Although mortality is significantly lower than in the prevaccination era, breakthrough COVID-19 in HM is still associated with considerable mortality. Death rate was lower in patients who received monoclonal antibodies, alone or in combination with antivirals.<\/jats:p>","DOI":"10.1182\/blood.2022017257","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T21:18:41Z","timestamp":1663708721000},"page":"2773-2787","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":76,"title":["Breakthrough COVID-19 in vaccinated patients with hematologic malignancies: results from the EPICOVIDEHA survey"],"prefix":"10.1182","volume":"140","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8287-928X","authenticated-orcid":false,"given":"Livio","family":"Pagano","sequence":"first","affiliation":[{"name":"1Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy"},{"name":"2Hematology Unit, Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6766-8297","authenticated-orcid":false,"given":"Jon","family":"Salmanton-Garc\u00eda","sequence":"additional","affiliation":[{"name":"3Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany"},{"name":"4Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6353-2272","authenticated-orcid":false,"given":"Francesco","family":"Marchesi","sequence":"additional","affiliation":[{"name":"5Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7167-7882","authenticated-orcid":false,"given":"Ola","family":"Blennow","sequence":"additional","affiliation":[{"name":"6Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6993-2450","authenticated-orcid":false,"given":"Maria","family":"Gomes da Silva","sequence":"additional","affiliation":[{"name":"7Portuguese Institute of Oncology, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2082-0738","authenticated-orcid":false,"given":"Andreas","family":"Glenth\u00f8j","sequence":"additional","affiliation":[{"name":"8Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, 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