{"entity": "journal", "iuid": "a1666a8b158940c69a669b0375e629d9", "timestamp": "2026-04-12T03:18:46.444Z", "links": {"self": {"href": "https://publications.scilifelab.se/journal/J%20Hematol.json"}, "display": {"href": "https://publications.scilifelab.se/journal/J%20Hematol"}}, "title": "J Hematol", "issn": "1927-1220", "issn-l": null, "publications_count": 1, "publications": [{"entity": "publication", "iuid": "ca2ebb4a8b1b45eba25eb2a5079f0e92", "links": {"self": {"href": "https://publications.scilifelab.se/publication/ca2ebb4a8b1b45eba25eb2a5079f0e92.json"}, "display": {"href": "https://publications.scilifelab.se/publication/ca2ebb4a8b1b45eba25eb2a5079f0e92"}}, "title": "Local and Systemic Immunity During Five Vaccinations Against SARS-CoV-2 in Zanubrutinib-Treated Patients With Chronic Lymphocytic Leukemia.", "authors": [{"family": "Andersson", "given": "Maria", "initials": "M"}, {"family": "Wu", "given": "Jinghua", "initials": "J"}, {"family": "Wullimann", "given": "David", "initials": "D"}, {"family": "Gao", "given": "Yu", "initials": "Y"}, {"family": "Aberg", "given": "Mikael", "initials": "M"}, {"family": "Muschiol", "given": "Sandra", "initials": "S"}, {"family": "Healy", "given": "Katie", "initials": "K"}, {"family": "Naud", "given": "Sabrina", "initials": "S"}, {"family": "Bogdanovic", "given": "Gordana", "initials": "G"}, {"family": "Palma", "given": "Marzia", "initials": "M"}, {"family": "Mellstedt", "given": "Hakan", "initials": "H"}, {"family": "Chen", "given": "Puran", "initials": "P"}, {"family": "Ljunggren", "given": "Hans-Gustaf", "initials": "HG"}, {"family": "Hansson", "given": "Lotta", "initials": "L"}, {"family": "Sallberg Chen", "given": "Margaret", "initials": "M"}, {"family": "Buggert", "given": "Marcus", "initials": "M"}, {"family": "Ingelman-Sundberg", "given": "Hanna M", "initials": "HM"}, {"family": "Osterborg", "given": "Anders", "initials": "A"}], "type": "journal article", "published": "2023-08-00", "journal": {"title": "J Hematol", "issn": "1927-1220", "volume": "12", "issue": "4", "pages": "170-175", "issn-l": null}, "abstract": "Patients with chronic lymphocytic leukemia (CLL) are vulnerable to coronavirus disease 2019 (COVID-19) and are at risk of inferior response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, especially if treated with the first-generation Bruton's tyrosine kinase inhibitor (BTKi) ibrutinib. We aimed to evaluate the impact of the third-generation BTKi, zanubrutinib, on systemic and mucosal response to SARS-CoV-2 vaccination.\n\nNine patients with CLL with ongoing zanubrutinib therapy were included and donated blood and saliva during SARS-CoV-2 vaccination, before vaccine doses 3 and 5 and 2 - 3 weeks after doses 3, 4, and 5. Ibrutinib-treated control patients (n = 7) and healthy aged-matched controls (n = 7) gave blood 2 - 3 weeks after vaccine dose 5. We quantified reactivity and neutralization capacity of SARS-CoV-2-specific IgG and IgA antibodies (Abs) in both serum and saliva, and reactivity of T cells activated with viral peptides.\n\nBoth zanubrutinib- and ibrutinib-treated patients had significantly, up to 1,000-fold, lower total spike-specific Ab levels after dose 5 compared to healthy controls (P < 0.01). Spike-IgG levels in serum from zanubrutinib-treated patients correlated well to neutralization capacity (r = 0.68; P < 0.0001) and were thus functional. Mucosal immunity (specific IgA in serum and saliva) was practically absent in zanubrutinib-treated patients even after five vaccine doses, whereas healthy controls had significantly higher levels (tested in serum after vaccine dose 5) (P < 0.05). In contrast, T-cell reactivity against SARS-CoV-2 peptides was equally high in zanubrutinib- and ibrutinib-treated patients as in healthy control donors.\n\nIn our small cohort of zanubrutinib-treated CLL patients, we conclude that up to five doses of SARS-CoV-2 vaccination induced no detectable IgA mucosal immunity, which likely will impair the primary barrier defence against the infection. Systemic IgG responses were also impaired, whereas T-cell responses were normal. Further and larger studies are needed to evaluate the impact of these findings on disease protection.", "doi": "10.14740/jh1140", "pmid": "37692865", "labels": {"Affinity Proteomics Uppsala": "Service"}, "xrefs": [{"db": "pmc", "key": "PMC10482612"}], "notes": [], "created": "2023-11-29T19:06:25.434Z", "modified": "2023-11-29T19:06:25.452Z"}], "created": "2023-11-29T19:06:25.442Z", "modified": "2023-11-29T19:06:25.442Z"}