Table 1. Summary of risk factors... | American Society of Hematology

Table 1.

Summary of risk factors associated with attenuated humoral and cellular immunogenicity after 2 doses of SARS-CoV-2 vaccination in HSCT recipients

Risk factors	pORs for positive immune responses (95% CI)	No. of cohorts∗	Levels of evidence (GRADE)
Humoral immune response
Host characteristics
Age >60 y	0.76 (0.49-1.18)	6²¹^,⁴⁸^,⁵⁴^,⁵⁷^,⁷⁸ (1 study with 2 cohorts)⁵⁷	Moderate
Male recipient	0.63 (0.49-0.83)	11²¹^,²⁴^,³⁷^,⁴⁸^,⁵²^,⁵⁷^,⁶⁷^,⁷¹^,⁷²^,⁷⁸ (1 study with 2 cohorts)⁵⁷	Moderate
Myeloid malignancy	1.47 (0.64-3.38)	8²⁴^,²⁶^,²⁹^,⁴⁸^,⁵²^,⁷¹^,⁷²^,⁷⁸	Moderate
Lymphoid malignancy	0.73 (0.45-1.19)	11²¹^,²⁶^,²⁹^,⁴⁸^,⁵²^,⁵⁷^,⁷¹^,⁷²^,⁷⁸ (2 studies with 2 cohorts)²⁶^,⁵⁷	Moderate
Acute leukemia	1.56 (0.86-2.84)	4²⁶^,⁷¹^,⁷²^,⁷⁸	Moderate
Nonmalignancy	1.53 (0.29-8.22)	3⁵²^,⁷¹^,⁷²	Moderate
Rituximab exposure within 6-12 mo	0.09 (0.03-0.21)	4²¹^,²⁶^,⁵²^,⁷⁴	Moderate
Complete remission status of underlying malignancy/indication for HSCT	2.55 (1.05-6.17)	3⁷¹^,⁷⁵ (1 study with 2 cohorts)⁷⁵	Moderate
HSCT characteristics
Donor
Matched sibling donor	1.51 (0.96-2.38)	7²⁴^,²⁶^,⁴⁸^,⁵²^,⁷¹^,⁷²^,⁷⁸	Moderate
Matched unrelated donor	1.12 (0.83-1.51)	7²⁴^,²⁶^,⁴⁸^,⁵²^,⁷¹^,⁷²^,⁷⁸	Moderate
Haploidentical donor	0.46 (0.22-0.95)	5²⁴^,²⁶^,⁴⁸^,⁵²^,⁷¹	Moderate
Conditioning regimen
MAC vs RIC	1.72 (1.30-2.28)	7²⁶^,⁴⁸^,⁵²^,⁵⁷^,⁷¹^,⁷²^,⁷⁸	Moderate
Time from transplant to vaccination
<6 mo	0.26 (0.15-0.48)	4²¹^,²⁷^,⁴⁰^,⁵⁴	Moderate
<12 mo	0.22 (0.10-0.46)	14²⁰^,²¹^,²⁴^,²⁷^,⁴⁰^,⁴⁸^,⁵²^,⁵⁵^,⁵⁷^,⁷¹^,⁷⁴^,⁷⁶ (2 studies with 2 cohorts)⁵⁵^,⁵⁷	Moderate
<24 mo	0.25 (0.07-0.89)	4³⁷^,⁴⁸^,⁷¹^,⁷⁶	Moderate
Post-HSCT characteristics
Any GVHD	0.54 (0.17-1.75)	4⁴⁸^,⁵²^,⁷¹^,⁷⁵	Moderate
Acute GVHD	0.61 (0.31-1.18)	3⁵⁷^,⁷²^,⁷⁸	Moderate
Chronic GVHD	0.57 (0.23-1.45)	7³⁷^,⁴⁰^,⁵⁷^,⁷¹^,⁷²^,⁷⁴^,⁷⁸	Moderate
Ongoing chemotherapy	0.48 (0.29-0.78)	4²⁶^,⁴⁶^,⁵² (1 study with 2 cohorts)²⁶	Moderate
Ongoing any IST	0.18 (0.13-0.25)	10²⁶^,³⁷^,⁴⁶^,⁴⁸^,⁵²^,⁷¹^,⁷²^,⁷⁵^,⁷⁸ (1 study with 2 cohorts)²⁶	Moderate
Ongoing corticosteroids	0.19 (0.12-0.31)	6²⁶^,⁵⁷^,⁷¹^,⁷²^,⁷⁴^,⁷⁸	Moderate
Ongoing calcineurin inhibitor	0.21 (0.15-0.29)	6²⁶^,⁵⁷^,⁷¹^,⁷²^,⁷⁴^,⁷⁸	Moderate
Ongoing mycophenolate mofetil	0.06 (0.01-0.35)	2²⁶^,⁷¹	Moderate
Lymphopenia (<1000 cells per μL)	0.18 (0.13-0.24)	5⁴⁸^,⁵²^,⁵⁴^,⁵⁷ (1 study with 2 cohorts)⁵⁷	Moderate
Hypogammaglobulinemia (IgG <6 g/L)	0.23 (0.10-0.55)	3⁵²^,⁵⁷ (1 study with 2 cohorts)⁵⁷	Moderate
Cellular immune response
Post-HSCT characteristics
Any GVHD	0.44 (0.18-1.06)	2³⁷^,⁴⁶	Moderate
Ongoing any IST	0.31 (0.10-0.99)	4³⁰^,³⁷^,³⁸^,⁴⁶	Low

Risk factors	pORs for positive immune responses (95% CI)	No. of cohorts∗	Levels of evidence (GRADE)
Humoral immune response
Host characteristics
Age >60 y	0.76 (0.49-1.18)	6²¹^,⁴⁸^,⁵⁴^,⁵⁷^,⁷⁸ (1 study with 2 cohorts)⁵⁷	Moderate
Male recipient	0.63 (0.49-0.83)	11²¹^,²⁴^,³⁷^,⁴⁸^,⁵²^,⁵⁷^,⁶⁷^,⁷¹^,⁷²^,⁷⁸ (1 study with 2 cohorts)⁵⁷	Moderate
Myeloid malignancy	1.47 (0.64-3.38)	8²⁴^,²⁶^,²⁹^,⁴⁸^,⁵²^,⁷¹^,⁷²^,⁷⁸	Moderate
Lymphoid malignancy	0.73 (0.45-1.19)	11²¹^,²⁶^,²⁹^,⁴⁸^,⁵²^,⁵⁷^,⁷¹^,⁷²^,⁷⁸ (2 studies with 2 cohorts)²⁶^,⁵⁷	Moderate
Acute leukemia	1.56 (0.86-2.84)	4²⁶^,⁷¹^,⁷²^,⁷⁸	Moderate
Nonmalignancy	1.53 (0.29-8.22)	3⁵²^,⁷¹^,⁷²	Moderate
Rituximab exposure within 6-12 mo	0.09 (0.03-0.21)	4²¹^,²⁶^,⁵²^,⁷⁴	Moderate
Complete remission status of underlying malignancy/indication for HSCT	2.55 (1.05-6.17)	3⁷¹^,⁷⁵ (1 study with 2 cohorts)⁷⁵	Moderate
HSCT characteristics
Donor
Matched sibling donor	1.51 (0.96-2.38)	7²⁴^,²⁶^,⁴⁸^,⁵²^,⁷¹^,⁷²^,⁷⁸	Moderate
Matched unrelated donor	1.12 (0.83-1.51)	7²⁴^,²⁶^,⁴⁸^,⁵²^,⁷¹^,⁷²^,⁷⁸	Moderate
Haploidentical donor	0.46 (0.22-0.95)	5²⁴^,²⁶^,⁴⁸^,⁵²^,⁷¹	Moderate
Conditioning regimen
MAC vs RIC	1.72 (1.30-2.28)	7²⁶^,⁴⁸^,⁵²^,⁵⁷^,⁷¹^,⁷²^,⁷⁸	Moderate
Time from transplant to vaccination
<6 mo	0.26 (0.15-0.48)	4²¹^,²⁷^,⁴⁰^,⁵⁴	Moderate
<12 mo	0.22 (0.10-0.46)	14²⁰^,²¹^,²⁴^,²⁷^,⁴⁰^,⁴⁸^,⁵²^,⁵⁵^,⁵⁷^,⁷¹^,⁷⁴^,⁷⁶ (2 studies with 2 cohorts)⁵⁵^,⁵⁷	Moderate
<24 mo	0.25 (0.07-0.89)	4³⁷^,⁴⁸^,⁷¹^,⁷⁶	Moderate
Post-HSCT characteristics
Any GVHD	0.54 (0.17-1.75)	4⁴⁸^,⁵²^,⁷¹^,⁷⁵	Moderate
Acute GVHD	0.61 (0.31-1.18)	3⁵⁷^,⁷²^,⁷⁸	Moderate
Chronic GVHD	0.57 (0.23-1.45)	7³⁷^,⁴⁰^,⁵⁷^,⁷¹^,⁷²^,⁷⁴^,⁷⁸	Moderate
Ongoing chemotherapy	0.48 (0.29-0.78)	4²⁶^,⁴⁶^,⁵² (1 study with 2 cohorts)²⁶	Moderate
Ongoing any IST	0.18 (0.13-0.25)	10²⁶^,³⁷^,⁴⁶^,⁴⁸^,⁵²^,⁷¹^,⁷²^,⁷⁵^,⁷⁸ (1 study with 2 cohorts)²⁶	Moderate
Ongoing corticosteroids	0.19 (0.12-0.31)	6²⁶^,⁵⁷^,⁷¹^,⁷²^,⁷⁴^,⁷⁸	Moderate
Ongoing calcineurin inhibitor	0.21 (0.15-0.29)	6²⁶^,⁵⁷^,⁷¹^,⁷²^,⁷⁴^,⁷⁸	Moderate
Ongoing mycophenolate mofetil	0.06 (0.01-0.35)	2²⁶^,⁷¹	Moderate
Lymphopenia (<1000 cells per μL)	0.18 (0.13-0.24)	5⁴⁸^,⁵²^,⁵⁴^,⁵⁷ (1 study with 2 cohorts)⁵⁷	Moderate
Hypogammaglobulinemia (IgG <6 g/L)	0.23 (0.10-0.55)	3⁵²^,⁵⁷ (1 study with 2 cohorts)⁵⁷	Moderate
Cellular immune response
Post-HSCT characteristics
Any GVHD	0.44 (0.18-1.06)	2³⁷^,⁴⁶	Moderate
Ongoing any IST	0.31 (0.10-0.99)	4³⁰^,³⁷^,³⁸^,⁴⁶	Low

IgG, immunoglobulin G; IST, immunosuppressive therapy.

∗

Both autologous HSCT and allogeneic HSCT cohorts from the same studies, for which data were accounted for 2 cohorts, had been included in some models.

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