Atanackovic Djordje, Luetkens Tim, Avila Stephanie V, Hardy Nancy M, Lutfi Forat, Sanchez-Petitto Gabriela, Vander Mause Erica, Glynn Nicole, Mannuel Heather D, Alkhaldi Hanan, Hankey Kim, Baddley John, Dahiya Saurabh, Rapoport Aaron P
Transplant and Cellular Therapy Program, Department of Medicine, University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA.
Department of Microbiology and Immunology, University of Maryland, Baltimore, MD 21201, USA.
Vaccines (Basel). 2021 Jul 3;9(7):737. doi: 10.3390/vaccines9070737.
Patients after autologous (autoSCT) and allogeneic stem cell transplantation (alloSCT) are at an increased risk of COVID-19-related morbidity and mortality, compounded by an immune system weakened by the underlying malignancy and prior treatments. Allogeneic transplantation, including stem cell and solid organ transplants, requires intensive immunosuppressive prophylaxis, which may further undermine the development of a protective vaccine-induced anti-viral immunity. Herein, we report on short- and long-term antiviral immune responses in two peri-stem cell transplant recipients and a third patient who received a COVID-19 vaccination after kidney transplantation. Our data indicate that: (1) patients post-alloSCT may be able to mount an anti-COVID-19 immune response; however, a sufficient time interval between transplant and exposure may be of critical importance; (2) alloSCT recipients with preexisting anti-SARS-CoV-2 immunity are at risk for losing protective humoral immunity following transplantation, particularly if the stem-cell donor lacks antiviral immunity, e.g., vaccine-derived immunity; and (3) some post-transplant patients are completely unable to build an immune response to a COVID-19 vaccine, perhaps based on the prophylactic suppression of T cell immunity.
自体造血干细胞移植（autoSCT）和异基因造血干细胞移植（alloSCT）后的患者感染新型冠状病毒肺炎（COVID-19）相关发病和死亡风险增加，潜在恶性肿瘤和既往治疗导致的免疫系统减弱使情况更加复杂。异基因移植，包括干细胞移植和实体器官移植，需要强化免疫抑制预防，这可能会进一步削弱保护性疫苗诱导的抗病毒免疫的发展。在此，我们报告了两名干细胞移植前后患者以及一名肾移植后接种COVID-19疫苗的患者的短期和长期抗病毒免疫反应。我们的数据表明：（1）alloSCT后的患者可能能够产生抗COVID-19免疫反应；然而，移植与接触病毒之间有足够的时间间隔可能至关重要；（2）已有抗严重急性呼吸综合征冠状病毒2（SARS-CoV-2）免疫力的alloSCT受者在移植后有失去保护性体液免疫的风险，特别是如果干细胞供体缺乏抗病毒免疫力，例如疫苗衍生的免疫力；（3）一些移植后患者完全无法对COVID-19疫苗产生免疫反应，这可能是由于T细胞免疫的预防性抑制。
