Gung Carol, McGuire Regina, George Mercy, Abdulkareem Abdullateef, Belden Katherine A, Porcu Pierluigi, Martinez-Outschoorn Ubaldo, Binder Adam F, Chervenova Inna, Alpdogan Onder
Division of Hematologic Malignancies, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States.
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States.
Front Oncol. 2022 Jul 7;12:840451. doi: 10.3389/fonc.2022.840451. eCollection 2022.
We retrospectively analyzed SARS-CoV-2 vaccination antibody responses in a cohort of 273 patients with lymphoproliferative disorders or plasma cell dyscrasias who were seen at a single tertiary cancer center. Semi-quantitative anti-spike protein serologic testing was performed with enzyme immunoassay method. We found that the antibody response rate to SARS-CoV-2 vaccination was 74.7% in our patient cohort with no difference based on gender, age or race. The highest response rate was found in patients with Multiple Myeloma (MM) (95.5%). The response rates found in Diffuse Large B-Cell Lymphoma (DLBCL), Chronic Lymphocytic Leukemia (CLL), and Low-Grade Non-Hodgkin Lymphoma (LG-NHL) were 73.2%, 61.5% and 53% respectively. We also evaluated the effects of receiving active chemo-immunotherapy on SARS-CoV-2 vaccination antibody response. We found that the patients on treatment had lower response than the patients off treatment (62.1% versus 84.4% p<0.001). Thirty-four of 58 LG-NHL patients were receiving anti-lymphoma treatment with a lower SARS-CoV-2 vaccination response as compared to the patients who were not on treatment (29.4% v 87.5% p<0.001). We observed a similar pattern in CLL patients receiving treatment (48.1 v 76.0 p:0.049). We found that only disease type and treatment status (on-treatment vs. off- treatment), but not gender, age or race were significant predictors of non-response in the multivariable logistic regression model. The interaction between disease type and treatment status was not statistically significant by multivariate analysis. In conclusion, receiving anti-cancer treatment was found to play a significant role in decreasing the response to COVID-19 vaccination.
我们对在一家单一的三级癌症中心就诊的273例淋巴增殖性疾病或浆细胞发育异常患者的队列进行了SARS-CoV-2疫苗接种抗体反应的回顾性分析。采用酶免疫测定法进行半定量抗刺突蛋白血清学检测。我们发现，在我们的患者队列中，SARS-CoV-2疫苗接种的抗体反应率为74.7%，基于性别、年龄或种族没有差异。在多发性骨髓瘤（MM）患者中发现最高反应率（95.5%）。弥漫性大B细胞淋巴瘤（DLBCL）、慢性淋巴细胞白血病（CLL）和低级别非霍奇金淋巴瘤（LG-NHL）的反应率分别为73.2%、61.5%和53%。我们还评估了接受积极的化学免疫治疗对SARS-CoV-2疫苗接种抗体反应的影响。我们发现，正在接受治疗的患者的反应低于未接受治疗的患者（62.1%对84.4%，p<0.001）。58例LG-NHL患者中有34例正在接受抗淋巴瘤治疗，其SARS-CoV-2疫苗接种反应低于未接受治疗的患者（29.4%对87.5%，p<0.001）。我们在接受治疗的CLL患者中观察到类似模式（48.1对76.0，p：0.049）。我们发现，在多变量逻辑回归模型中，只有疾病类型和治疗状态（正在治疗与未治疗），而不是性别、年龄或种族是非反应的显著预测因素。通过多变量分析，疾病类型和治疗状态之间的相互作用没有统计学意义。总之，发现接受抗癌治疗在降低对COVID-19疫苗接种的反应中起重要作用。
