Understanding antibody-based SARS-CoV-2 immunity in hematologic malignancy (HM) patients following infection is crucial to inform vaccination strategies for this highly vulnerable population. This cross-sectional study documents the anti-SARS-CoV-2 humoral response and serum neutralizing activity in 189 HM patients recovering from a PCR-confirmed infection. The overall seroconversion rate was 85.7%, with the lowest values in patients with lymphoid malignancies or undergoing chemotherapy. Therapy-naive patients in the “watch and wait” status were more likely to seroconvert and display increased anti-s IgG titers. Enhanced serum neutralizing activity was observed in the following SARS-CoV-2-infected HM patient groups: (i) males; (ii) severe COVID-19; and (iii) “watch and wait” or “complete/partial response”. The geometric mean (GeoMean) ID50 neutralization titers in patients analyzed before or after 6 months post-infection were 299.1 and 306.3, respectively, indicating that >50% of the patients in either group had a neutralization titer sufficient to provide 50% protection from symptomatic COVID-19. Altogether, our findings suggest that therapy-naive HM patients mount a far more robust immune response to SARS-CoV-2 infection vs. patients receiving anti-cancer treatment, raising the important question as to whether HM patients should be vaccinated before therapy and/or receive vaccine formats capable of better recapitulating the natural infection.

了解血液恶性肿瘤 (HM) 患者感染后基于抗体的 SARS-CoV-2 免疫力对于为这一高度脆弱人群制定疫苗接种策略至关重要。这项横断面研究记录了 189 名从 PCR 确诊的感染中恢复的 HM 患者的抗 SARS-CoV-2 体液反应和血清中和活性。总体血清转化率为85.7%，在淋巴恶性肿瘤或接受化疗的患者中最低。处于“观察和等待”状态的初治患者更有可能发生血清转化并表现出抗 s IgG 滴度增加。在以下感染 SARS-CoV-2 的 HM 患者组中观察到血清中和活性增强： (i)男性； ( ii)严重的 COVID-19； ( iii) “观察并等待”或“完整/部分响应”。在感染后 6 个月之前或之后分析的患者的几何平均 (GeoMean) ID50 中和滴度分别为 299.1 和 306.3，表明任一组中 >50% 的患者具有足以提供 50% 的症状保护的中和滴度。 2019冠状病毒病。总而言之，我们的研究结果表明，与接受抗癌治疗的患者相比，未经治疗的 HM 患者对 SARS-CoV-2 感染产生了更强的免疫反应，这提出了一个重要问题：HM 患者是否应该在治疗前接种疫苗和/或接受能够更好地再现自然感染的疫苗形式。