Author Credentials

Mukul Singal, MD.1

Sanjana Kalvehalli Kashinath, MD.1

S. Shahzad Mustafa, MD.2,3

Edward Walsh, MD.4

Karthik Vadamalai, MD.5

Saad Jamshed, MD.1

  1. Department of Hematology and Oncology, Rochester General Hospital, Rochester, NY
  2. Allergy, Immunology and Rheumatology, University of Rochester School of Medicine and Dentistry, Rochester, NY
  3. Allergy, Immunology, and Rheumatology, Rochester Regional Health, Rochester, NY
  4. Department of Infectious Diseases and Immunology, Rochester General Hospital, Rochester, NY
  5. Mercy Hospital Springfield, Springfield, MO


Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the current COVID-19 pandemic. There is emerging evidence regarding suboptimal response to vaccination against COVID-19 in patients with hematologic and solid organ malignancies.

We conducted a single-center prospective study assessing seroconversion in response to vaccination against COVID-19 in 53 patients with chronic lymphocytic leukemia (CLL), non-Hodgkin’s lymphoma (NHL), multiple myeloma (MM), and solid organ malignancies.

A quantitative immunoassay of IgG antibodies to SARS-CoV-2 Spike (S) protein was measured prior to vaccination and at 2 weeks after completion of two-dose vaccination series. A fourfold increase in antibody titers was considered positive seroconversion. Through a predesigned survey, patients also self-reported side effects from each dose of vaccination.

Seroconversion on vaccination was seen in 6/12 (50%) patients with CLL, 7/11 (63.6%) patients with NHL, 9/10 (90%) patients with MM, and 17/20 (85%) patients with solid organ malignancy. Only 6 of the 14 (42.8%) patients currently on or with previous history of rituximab use seroconverted. Injection site soreness was the most reported side effect. The only severe side effect occurred in a patient with solid organ malignancy who developed Parsonage-Turner syndrome.

Patients with CLL and NHL appear less likely to respond to vaccination against COVID-19 in contrast to patients with MM or solid organ malignancies. Previous treatment with

rituximab is a possible risk factor for suboptimal response to vaccination.

These data highlight the importance of continuing risk mitigation strategies against COVID-19 in individuals with hematologic malignancy, particularly those with CLL or on treatment with rituximab.

Creative Commons License

Creative Commons Attribution-NonCommercial 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

COVID_19_Vaccine_Study_Revised_Formatted.docx (193 kB)
Reformatted manuscript

Figure 1.docx (38 kB)
Figure 1

Figure 2.docx (38 kB)
Figure 2

Figure 3.docx (24 kB)
Figure 3

Table 1.docx (21 kB)
Table 1

Table 2.docx (32 kB)
Table 2

Table 3.docx (27 kB)
Table 3