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Keppler-Hafkemeyer, Andrea; Greil, Christine; Wratil, Paul R.; Shoumariyeh, Khalid; Stern, Marcel; Hafkemeyer, Annika; Ashok, Driti; Hollaus, Alexandra; Lupoli, Gaia; Priller, Alina; Bischof, Marie L.; Ihorst, Gabriele; Engelhardt, Monika; Marks, Reinhard; Finke, Juergen; Bertrand, Hannah; Daechert, Christopher; Muenchhoff, Maximilian; Badell, Irina; Emmerich, Florian; Halder, Hridi; Spaeth, Patricia M.; Knolle, Percy A.; Protzer, Ulrike; Bergwelt-Baildon, Michael von; Duyster, Justus; Hartmann, Tanja N.; Moosmann, Andreas and Keppler, Oliver T. (2022): Potent high-avidity neutralizing antibodies and T cell responses after COVID-19 vaccination in individuals with B cell lymphoma and multiple myeloma. In: Nature Cancer, Vol. 4, No. 1: pp. 81-95

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Individuals with hematologic malignancies are at increased risk for severe coronavirus disease 2019 (COVID-19), yet profound analyses of COVID-19 vaccine-induced immunity are scarce. Here we present an observational study with expanded methodological analysis of a longitudinal, primarily BNT162b2 mRNA-vaccinated cohort of 60 infection-naive individuals with B cell lymphomas and multiple myeloma. We show that many of these individuals, despite markedly lower anti-spike IgG titers, rapidly develop potent infection neutralization capacities against several severe acute respiratory syndrome coronavirus 2 variants of concern (VoCs). The observed increased neutralization capacity per anti-spike antibody unit was paralleled by an early step increase in antibody avidity between the second and third vaccination. All individuals with hematologic malignancies, including those depleted of B cells and individuals with multiple myeloma, exhibited a robust T cell response to peptides derived from the spike protein of VoCs Delta and Omicron (BA.1). Consistently, breakthrough infections were mainly of mild to moderate severity. We conclude that COVID-19 vaccination can induce broad antiviral immunity including ultrapotent neutralizing antibodies with high avidity in different hematologic malignancies.

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