Hematology Department, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErsHenri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 51 avenue du Mal de Lattre de Tassigny, 94010, Créteil Cedex, France.
INSERM U955, Paris Est Créteil University UPEC, Créteil, France.
J Hematol Oncol. 2022 Mar 18;15(1):27. doi: 10.1186/s13045-022-01250-2.
Hematopoietic stem cell transplant (HSCT) recipients are at high-risk for severe COVID-19 and have altered immune responses to vaccination. We sought to evaluate the dynamics of immune response to BNT162b2 mRNA vaccine in HSCT recipients. We systematically proposed vaccination with BNT162b2 to HSCT recipients and gave a third vaccine dose to those showing titers of IgG(S-RBD) below 4160 AU/mL 1 month following the second dose. We then quantified anti-SARS-CoV-2 antibodies dynamics in 133 of these HSCT recipients (88 after two and 45 after three vaccine doses) 6 months after the first vaccine dose. Mean IgG(S-RBD) titer at 6 months was significantly lower than the peak value measured 1 month after a second (p < 0.001) or third (p < 0.01) vaccine dose. IgG(S-RBD) titers at 6 months were strongly correlated to peak values (p < 0.001) and a peak titer above 10,370 AU/mL predicted persistent protection at 6 months. Seventy-two percent (96/133) of patients retained protective antibody levels at 6 months. Immunosuppressive drugs and low lymphocyte counts in peripheral blood correlated with lower IgG(S-RBD) titers at 6 months. Four patients (3%) developed PCR-documented SARS-CoV-2 infection and one died.
造血干细胞移植（HSCT）受者患严重 COVID-19 的风险较高，并且对疫苗接种的免疫反应发生改变。我们试图评估 HSCT 受者对 BNT162b2 mRNA 疫苗的免疫反应动态。我们系统地向 HSCT 受者提出接种 BNT162b2 的建议，并在第二剂疫苗接种后 1 个月，如果 IgG(S-RBD)滴度低于 4160 AU/mL，则给这些受者接种第三剂疫苗。然后，我们在首次接种疫苗后 6 个月对这 133 名 HSCT 受者（88 名接种了两剂，45 名接种了三剂）的抗 SARS-CoV-2 抗体动态进行了定量分析。6 个月时的 IgG(S-RBD)平均滴度明显低于第二次（p<0.001）或第三次（p<0.01）疫苗接种后 1 个月的峰值。6 个月时的 IgG(S-RBD)滴度与峰值高度相关（p<0.001），峰值滴度高于 10,370 AU/mL 预测 6 个月时持续保护。72%（96/133）的患者在 6 个月时保留了保护性抗体水平。免疫抑制药物和外周血中淋巴细胞计数低与 6 个月时 IgG(S-RBD)滴度较低相关。有 4 名患者（3%）发生了经 PCR 证实的 SARS-CoV-2 感染，其中 1 名患者死亡。
