Narita Kentaro, Nakaji So, Tabata Rikako, Terao Toshiki, Kuzume Ayumi, Tsushima Takafumi, Ikeda Daisuke, Fukumoto Ami, Miura Daisuke, Takeuchi Masami, Doi Masahiro, Umezawa Yuka, Otsuka Yoshihito, Takamatsu Hiroyuki, Matsue Kosei
Division of Hematology/Oncology, Department of Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan.
Department of Gastroenterology, Kameda Medical Center, Kamogawa, Chiba, Japan.
Int J Hematol. 2022 May;115(5):728-736. doi: 10.1007/s12185-022-03305-z. Epub 2022 Feb 21.
Patients with lymphoma are at increased risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); therefore, evaluation of SARS-CoV-2 vaccination efficacy is essential. We conducted a prospective observational study to monitor the antibody response in 500 patients with lymphoma after SARS-CoV-2 vaccination. Antibody levels increased in a stepwise manner after the first and second dose of the vaccine. After completion of the two-dose series, anti-S antibody was negative in 109 patients (21.8%), and below clinically protective levels (anti-S ≥ 264 U/mL) in 236 patients (47.2%). The median anti-S titers at 0-6 months, 7-12 months, 13-24 months, and 24 months after treatment completion were 0.4 U/mL, 3.8 U/mL, 270 U/mL, and 650 U/mL, respectively. Multivariate analysis showed that receiving the vaccine < 6 months since completing treatment, white blood cell count < 5050/μL, percentage of CD19 + cells < 10%, CD4 + cells < 27%, immunoglobulin (Ig) A < 195 mg/dL, IgM < 50 mg/dL, serum soluble interleukin 2 receptor > 600 U/mL, and presence of lymphoma cells in the peripheral blood were significantly correlated with anti-S < 264 U/mL. Lymphoma patients had variably impaired antibody response to the SARS-CoV-2 vaccine. We identified various factors to predict COVID-19 vaccine effectiveness in lymphoma patients that may help tailoring possible vaccine boosters.
淋巴瘤患者感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的风险增加；因此，评估SARS-CoV-2疫苗的疗效至关重要。我们进行了一项前瞻性观察研究，以监测500例淋巴瘤患者接种SARS-CoV-2疫苗后的抗体反应。在接种第一剂和第二剂疫苗后，抗体水平呈逐步上升趋势。在完成两剂疫苗接种后，109例患者（21.8%）的抗S抗体呈阴性，236例患者（47.2%）的抗S抗体低于临床保护水平（抗S≥264 U/mL）。治疗完成后0至6个月、7至12个月、13至24个月和24个月时的抗S抗体滴度中位数分别为0.4 U/mL、3.8 U/mL、270 U/mL和650 U/mL。多变量分析显示，治疗完成后<6个月接种疫苗、白细胞计数<5050/μL、CD19+细胞百分比<10%、CD4+细胞<27%、免疫球蛋白（Ig）A<195 mg/dL、IgM<50 mg/dL、血清可溶性白细胞介素2受体>600 U/mL以及外周血中存在淋巴瘤细胞与抗S<264 U/mL显著相关。淋巴瘤患者对SARS-CoV-2疫苗的抗体反应存在不同程度的受损。我们确定了多种预测淋巴瘤患者COVID-19疫苗有效性的因素，这可能有助于定制可能的疫苗加强针。
