Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The University of Chicago Medicine, 5841 S. Maryland Ave. MC 4076, Chicago, IL, 60637, USA.
J Hematol Oncol. 2022 Feb 5;15(1):15. doi: 10.1186/s13045-022-01233-3.
Patients with cancer have an increased risk of coronavirus disease 2019 (COVID-19) and an attenuated responses to various vaccines. This meta-analysis aims to assess the serologic response to COVID-19 vaccination in patients with cancer.
Electronic databases were systematically searched on August 1, 2021 for studies that reported the serologic response to COVID-19 vaccine in cancer patients. Random effects models were used to achieve pooled serologic response rates and odds ratios (ORs).
We analyzed 16 observational studies with a total of 1453 patients with cancer. A majority of studies used mRNA vaccines (BNT162b2 or mRNA-1273). The proportion of patients achieving a serologic response after a single and two doses of COVID-19 vaccine were 54.2% (95% confidence interval [CI] 41.0-66.9) and 87.7% (95% CI 82.5-91.5), respectively. Patients with hematologic cancers had a lower response rate after the second dose of vaccine compared to those with solid organ cancers (63.7% vs. 94.9%), which was attributable to the low response rates associated with certain conditions (chronic lymphocytic leukemia, lymphoma) and therapies (anti-CD20, kinase inhibitors). A lower proportion of patients with cancer achieved a serologic response compared to control patients after one and two doses of vaccine (OR0.073 [95% CI 0.026-0.20] and 0.10 [95% CI 0.039-0.26], respectively).
Patients with cancer, especially those with hematologic B-cell malignancies, have a lower serologic response to COVID-19 vaccines. The results suggest that cancer patients should continue to follow safety measures including mask-wearing after vaccination and suggest the need for additional strategies for prophylaxis.
癌症患者罹患 2019 年冠状病毒病（COVID-19）的风险增加，并且对各种疫苗的反应减弱。本荟萃分析旨在评估癌症患者对 COVID-19 疫苗的血清学反应。
系统检索了 2021 年 8 月 1 日电子数据库中关于报道癌症患者 COVID-19 疫苗血清学反应的研究。使用随机效应模型计算血清学反应率和比值比（OR）的合并值。
我们分析了 16 项观察性研究，共纳入 1453 例癌症患者。大多数研究使用信使 RNA 疫苗（BNT162b2 或 mRNA-1273）。单次和两次 COVID-19 疫苗接种后产生血清学反应的患者比例分别为 54.2%（95%置信区间 [CI] 41.0-66.9）和 87.7%（95% CI 82.5-91.5）。与实体器官癌症患者相比，血液系统癌症患者第二次疫苗接种后的反应率较低（63.7%比 94.9%），这归因于某些疾病（慢性淋巴细胞白血病，淋巴瘤）和治疗方法（抗-CD20，激酶抑制剂）导致的低反应率。与对照组患者相比，癌症患者单次和两次接种疫苗后产生血清学反应的比例较低（OR0.073 [95% CI 0.026-0.20] 和 0.10 [95% CI 0.039-0.26]）。
癌症患者，尤其是血液系统 B 细胞恶性肿瘤患者，对 COVID-19 疫苗的血清学反应较低。结果表明，癌症患者在接种疫苗后应继续遵循包括戴口罩在内的安全措施，并建议采取额外的预防策略。
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