Terpos Evangelos, Gavriatopoulou Maria, Fotiou Despina, Giatra Chara, Asimakopoulos Ioannis, Dimou Maria, Sklirou Aimilia D, Ntanasis-Stathopoulos Ioannis, Darmani Ismini, Briasoulis Alexandros, Kastritis Efstathios, Angelopoulou Maria, Baltadakis Ioannis, Panayiotidis Panayiotis, Trougakos Ioannis P, Vassilakopoulos Theodoros P, Pagoni Maria, Dimopoulos Meletios A
Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece.
BMT Unit, Department of Hematology and Lymphomas, Evangelismos General Hospital, 10676 Athens, Greece.
Cancers (Basel). 2021 Sep 6;13(17):4480. doi: 10.3390/cancers13174480.
Emerging data suggest suboptimal antibody responses to COVID-19 vaccination in patients with hematological malignancies. We evaluated the humoral response following the BNT162b2 vaccine in patients with chronic lymphocytic leukemia (CLL), non-Hodgkin's lymphoma (NHL), and Hodgkin's lymphoma (HL). An FDA-approved, ELISA-based methodology was implemented to evaluate the titers of neutralizing antibodies (NAbs) against SARS-CoV-2 on day 1 of the first vaccine, and afterwards on day 22 and 50. One hundred and thirty-two patients with CLL/lymphomas and 214 healthy matched controls vaccinated during the same period, at the same center were enrolled in the study (NCT04743388). Vaccination with two doses of the BNT162b2 vaccine led to lower production of NAbs against SARS-CoV-2 in patients with CLL/lymphomas compared with controls both on day 22 and on day 50 ( < 0.001 for all comparisons). Disease-related immune dysregulation and therapy-related immunosuppression are involved in the low humoral response. Importantly, active treatment with Rituximab, Bruton's tyrosine kinase inhibitors, or chemotherapy was an independent prognostic factor for suboptimal antibody response. Patients with HL showed superior humoral responses to the NHL/CLL subgroups. In conclusion, patients with CLL/lymphomas have low humoral response following COVID-19 vaccination, underlining the need for timely vaccination ideally during a treatment-free period and for continuous vigilance on infection control measures.
新出现的数据表明，血液系统恶性肿瘤患者对新冠疫苗的抗体反应欠佳。我们评估了慢性淋巴细胞白血病（CLL）、非霍奇金淋巴瘤（NHL）和霍奇金淋巴瘤（HL）患者接种BNT162b2疫苗后的体液免疫反应。采用美国食品药品监督管理局（FDA）批准的基于酶联免疫吸附测定（ELISA）的方法，在首次接种疫苗的第1天、之后的第22天和第50天评估针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的中和抗体（NAbs）滴度。132例CLL/淋巴瘤患者和214例在同一时期、同一中心接种疫苗的健康匹配对照者纳入本研究（NCT04743388）。与对照组相比，接种两剂BNT162b2疫苗后，CLL/淋巴瘤患者在第22天和第50天针对SARS-CoV-2的NAbs产生量均较低（所有比较均P<0.001）。疾病相关的免疫失调和治疗相关的免疫抑制与体液免疫反应低下有关。重要的是，使用利妥昔单抗、布鲁顿酪氨酸激酶抑制剂或化疗进行积极治疗是抗体反应欠佳的独立预后因素。HL患者的体液免疫反应优于NHL/CLL亚组。总之，CLL/淋巴瘤患者在新冠疫苗接种后体液免疫反应较低，这突出表明理想情况下需要在无治疗期及时接种疫苗，并持续严格采取感染控制措施。
