Division of Infectious Disease, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States of America.
Division of Infectious Disease, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States of America.
Blood Rev. 2022 Nov;56:100984. doi: 10.1016/j.blre.2022.100984. Epub 2022 Jun 12.
Individuals with hematological malignancies and hematopoietic stem cell transplant (HCT) recipients are immunologically heterogenous groups with varying degrees of immunosuppression at increased risk of severe disease and mortality from SARS-CoV-2 infection. SARS-CoV-2 vaccines are key interventions to preventing severe COVID-19 and its complications. While these individuals were excluded from initial vaccine trials, there is now a growing body of acceptable safety and immunogenicity data among these individuals. A consistent signal for new or worsening graft versus host disease in allogeneic HCT recipients has not been demonstrated post-vaccination. Immunogenicity in these populations is variable depending on disease and treatment factors. However, serological responses may not accurately reflect vaccine protection as correlates of protection within these populations are not yet established. Large-scale studies powered to identify rare serious events, resolve differences in vaccine responses between different vaccination strategies, and identify immune correlates of protection within these populations are needed.
患有血液系统恶性肿瘤和造血干细胞移植 (HCT) 受者的个体免疫状态具有异质性，免疫抑制程度不同，感染 SARS-CoV-2 后发生重症疾病和死亡的风险增加。SARS-CoV-2 疫苗是预防重症 COVID-19 及其并发症的关键干预措施。虽然这些个体最初被排除在疫苗试验之外，但现在有越来越多的可接受的安全性和免疫原性数据在这些个体中得到证实。接种疫苗后，并未在所有异基因 HCT 受者中观察到新的或恶化的移植物抗宿主病的一致信号。这些人群的免疫原性因疾病和治疗因素而异。然而，血清学反应可能无法准确反映疫苗的保护作用，因为这些人群中的保护相关因素尚未建立。需要开展大规模研究，以确定罕见的严重事件，解决不同疫苗接种策略之间的疫苗反应差异，并确定这些人群中的免疫保护相关因素。
