This is a non-profit multicenter observational study, coordinated by the Department of
OncoHematology,Cell Therapy, Gene Therapies and Hematopoietic Transplantation of the
Bambino Gesù Children'sHospital, IRCCS which provides for the collectionof clinical data
of patients with an established diagnosis of TDT and SCD after the administration of the
anti-SARS-CoV-2vaccine.

As this is a prospective study for medium-term assessments, it is expected to last no
less than 18 months. The duration of the prospective observation will start from April
2021 for the duration of 12 months.

Setting

The following will be enrolled:

- for the main study patients diagnosed with TDT and SCD even if they have previously
contracted SARS-CoV-2 infection;

- for the first substudy, patients with TDT and SCD diagnosis will be enrolled,
divided by presence/absence of hypo/asplenia;

- for the second substudy, patients diagnosed with TDT and hypo/asplenic SCD will be
enrolled.

The Scientific Committee of the project discussed and approved a dataset that will be
collected by local centers, the pseudo-anonymized data of patients collected in a special
e-CRF.

The participating centers are:

- Rome, Brindisi, Cagliari, Genoa, Ferrara, Milan, Naples, Palermo Turin, Verona.

The Italian Society of Thalassemia and Hemoglobinopathies (SITE) in its role as a
scientific society of reference for the pathology will act as Promoter of the
experimentation and the ForAnemia Foundation, a non-profit organization, is also
identified as a funder of the present study.

The project will be developed through the creation and validation of a data collection
card in which the clinical data relating to all patients with the characteristics of
inclusion in the participating centers will be entered.

The data to be entered include characteristics of the patient, in addition to
epidemiological data (sex, age) and clinical data (diagnosis), pre-existing
comorbidities, indication of iron overload, drugs administered. Data analysis will be
primarily descriptive.

It is accepted in advance that this protocol may require repeated modifications to
conform to the evolution of knowledge about the pandemic, the complication rate and the
therapeutic scenario. A high degree of adaptation is therefore expected, which will be
rigorously discussed with the independent data monitoring committee that will be
appointed immediately after the approval of the protocol.

Study population Patients with TDT and SCD. Inclusion criteria

Main study and first substudy:

- Patients with advancedTDT and SCD diagnosis, age > 18 years

- signature of informed consent.

Second substudy:

- Splenectomized patients withTDT and SCD diagnosed, age > 18 years

- signature of informed consent. Exclusion criteria No signature informed consent.
Results of the Study

The following variables will be measured:

- anti_N Antibody Value

- Anti-RBD values

- memory andi-trimeric Spike IgG in total memory (% of total IgG memory)

- Immunity value T (IFN-g) Variables Samples for the analysis of humoral and
cell-mediated response will be collected before vaccination (T0), at booster (T1),
between 14 and 21 days after recall (T2) and after 12, 24 and 52 weeks after
vaccination.

Sampling before vaccination (T0) can be collected up to 5 days before vaccination.
Sampling prior to administration of the booster (T1) may be collected up to 5 days in
advance.

Withdrawals at weeks 12, 24, 52 will be performed with a tolerance of 10 days.

- The analysis of the presence of specific antibodies (IgG) to N and S viral antigens
will be carried out by CMIA method. The analysis of both antibodies will allow to
evaluate the response to the vaccine (anti-S antibodies) and a possible natural
exposure/infection (anti-N antibodies). In patients who present anti-S antibodies,
neutralizing titiness measurement will be performed.