Fig. 2: Antibody responses but not cellular responses to SARS-CoV-2 vaccination are impaired by systemic therapy.
a, Participants with lymphoma vaccinated with ChAdOx1 vaccine while on systemic treatment or within 24 weeks of treatment completion (designated ‘on treatment’) had reduced antibody levels compared to participants with previous or untreated lymphoma (designated ‘no treatment’) and healthy controls (designated ‘healthy donors’). The dashed line and shaded region indicate undetectable antibody. GMC is shown; two-sided Kruskal–Wallis test, Dunn’s test for multiple comparisons, ****P < 0.0001. b, As in a but with BNT162b2 where the same phenomenon is observed. c, Reduced anti-S IgG antibody levels in HL, aggressive B-NHL (A B-NHL) and indolent B-NHL (I B-NHL) participants in the ‘on treatment’ group and in I B-NHL participants in the ‘no treatment’ group despite two vaccine doses. GMC is shown; two-sided Kruskal–Wallis test, Dunn’s test for multiple comparisons, *P = 0.0288, **P = 0.0008, ***P = 0.0004, ****P < 0.0001. d, Anti-S levels in participants with I B-NHL are similar between those who had received previous antisystemic therapy compared to treatment-naive. GMC is shown; two-sided Kruskal–Wallis test. P <0.05 was considered significant. e, Univariable logistic regression showing that low serum IgG, anti-CD20 exposure 12 months preceding the first vaccine dose; ‘on treatment’ group and older age (represented by ‘Age’ as a continuous variable) were associated with an increased OR of having undetectable anti-S IgG. Participants with HL favored detectable anti-S IgG. n = 428 participants. Error bars represent 95% CI. *P = 0.005, **P = 0.001, ***P < 0.001. f, Similar IFN-γ cellular responses in participants with lymphoma between ‘on’ and ‘no treatment’ groups. The dashed line and shaded region indicate a negative IFN-γ response. Median and 95% CI are shown; two-sided Kruskal–Wallis test, Dunn’s test for multiple comparisons, *P = 0.0132, **P = 0.0023, ****P < 0.0001. g, Reduced IFN-γ cellular responses were preserved in participants with lymphoma except for those with I B-NHL in the ‘no treatment’ group. The dashed line and shaded region indicate a negative IFN-γ response. Median and 95% CI are shown; two-sided Kruskal–Wallis test, Dunn’s test for multiple comparisons, *P = 0.0356, **P = 0.0262, ***P = 0.0093, ****P = 0.0010, *****P < 0.0001.
