{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T05:01:15Z","timestamp":1771304475242,"version":"3.50.1"},"reference-count":57,"publisher":"American Society of Hematology","issue":"25","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,12,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Patients with chronic lymphocytic leukemia (CLL) or monoclonal B-lymphocytosis (MBL) have impaired response to COVID-19 vaccination. A total of 258 patients (215 with CLL\u00a0and 43 with MBL) had antispike antibody levels evaluable for statistical analysis. The overall seroconversion rate in patients with CLL was 94.2% (antispike antibodies \u226550 AU\/mL) and 100% in patients with MBL after multiple vaccine doses. After 3 doses (post-D3) in 167 patients with CLL, 73.7% were seropositive, 17.4% had antispike antibody levels between 50 and 999 AU\/mL, and 56.3% had antispike antibody levels \u22651000 AU\/mL, with a median rise from 144.6 to 1800.7 AU\/mL. Of patients who were seronegative post-D2, 39.7% seroconverted post-D3. For those who then remained seronegative after their previous dose, seroconversion occurred in 40.6% post-D4, 46.2% post-D5, 16.7% post-D6, and 0% after D7 or D8. After seroconversion, most had a progressive increase in antispike antibody levels. Neutralization was associated with higher antispike antibody levels, more vaccine doses, and earlier severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants; neutralizing antibody against early clade D614G was detected in 65.3%, against Delta in 52.0%, and against Omicron in 36.5%. SARS-CoV-2\u2013specific T-cell production of interferon \u03b3 and interleukin 2 occurred in 73.9% and 60.9%, respectively, of 23 patients tested. After multiple vaccine doses, by multivariate analysis, immunoglobulin M \u22650.53 g\/L, immunoglobulin subclass G3 \u22650.22 g\/L and absence of current CLL therapy were independent predictors of positive serological responses. Multiple sequential COVID-19 vaccination significantly increased seroconversion and antispike antibody levels in patients with CLL or MBL.<\/jats:p>","DOI":"10.1182\/blood.2022017814","type":"journal-article","created":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T19:55:02Z","timestamp":1665172502000},"page":"2709-2721","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":36,"title":["Multiple COVID-19 vaccine doses in CLL and MBL improve immune responses with progressive and high seroconversion"],"prefix":"10.1182","volume":"140","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1344-5143","authenticated-orcid":false,"given":"Yandong","family":"Shen","sequence":"first","affiliation":[{"name":"1Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia"},{"name":"2Kolling Institute, Royal North Shore Hospital, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6337-1496","authenticated-orcid":false,"given":"Jane A.","family":"Freeman","sequence":"additional","affiliation":[{"name":"3Department of Haematology and Flow Cytometry, Laverty Pathology, Sydney, NSW, Australia"},{"name":"4Northern Haematology and Oncology Group, Sydney Adventist Hospital, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliette","family":"Holland","sequence":"additional","affiliation":[{"name":"5Department of Microbiology, Laverty Pathology, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kartik","family":"Naidu","sequence":"additional","affiliation":[{"name":"5Department of Microbiology, Laverty Pathology, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0432-0226","authenticated-orcid":false,"given":"Ann","family":"Solterbeck","sequence":"additional","affiliation":[{"name":"6Statistical Revelations Pty Ltd, Ocean Grove, VIC, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nenna","family":"Van Bilsen","sequence":"additional","affiliation":[{"name":"3Department of Haematology and Flow Cytometry, Laverty Pathology, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Downe","sequence":"additional","affiliation":[{"name":"3Department of Haematology and Flow Cytometry, Laverty Pathology, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7445-4660","authenticated-orcid":false,"given":"Ian","family":"Kerridge","sequence":"additional","affiliation":[{"name":"1Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucinda","family":"Wallman","sequence":"additional","affiliation":[{"name":"7Department of Immunology, Laverty Pathology, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anouschka","family":"Akerman","sequence":"additional","affiliation":[{"name":"8Kirby Institute, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anupriya","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"8Kirby Institute, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Milogiannakis","sequence":"additional","affiliation":[{"name":"8Kirby Institute, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9807-7211","authenticated-orcid":false,"given":"Gabriela","family":"Martins Costa Gomes","sequence":"additional","affiliation":[{"name":"9Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chloe M.","family":"Doyle","sequence":"additional","affiliation":[{"name":"9Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6894-935X","authenticated-orcid":false,"given":"Kerrie J.","family":"Sandgren","sequence":"additional","affiliation":[{"name":"9Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1918-5343","authenticated-orcid":false,"given":"Stuart","family":"Turville","sequence":"additional","affiliation":[{"name":"8Kirby Institute, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6744-5667","authenticated-orcid":false,"given":"Anthony L.","family":"Cunningham","sequence":"additional","affiliation":[{"name":"9Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1928-2098","authenticated-orcid":false,"given":"Stephen P.","family":"Mulligan","sequence":"additional","affiliation":[{"name":"1Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia"},{"name":"2Kolling Institute, Royal North Shore Hospital, Sydney, NSW, 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