Gössi Simona, Bacher Ulrike, Haslebacher Claudia, Nagler Michael, Suter Franziska, Staehelin Cornelia, Novak Urban, Pabst Thomas
Department of Medical Oncology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland.
Department of Hematology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland.
Cancers (Basel). 2022 Jul 20;14(14):3527. doi: 10.3390/cancers14143527.
: Due to B-cell aplasia following CAR-T-cell therapy, patients are at risk of severe SARS-CoV-2 course. : COVID-19 vaccines were assessed by IgG antibody tests against SARS-CoV-2 spike protein (anti-S1/S2). Vaccination procedures: group (1): CAR-T-cells followed by two to four vaccine doses; group (2): Two vaccine doses prior to CAR-T-cells, followed by doses 3 or 4. : In group 1 ( = 32), 7/30 patients (23.2%) had positive antibody tests after a second dose, 9/23 (39.1%) after a third dose, and 3/3 patients after a fourth dose. A third dose led to seroconversion in 5 of 21 patients (23.8%) with available data, while a fourth dose did so in 2/3 patients. Higher B-cells (AUC: 96.2%, CI: 89-100, = 0.0006) and lower CAR-T-cell copies (AUC: 77.3%, CI: 57-97, = 0.0438) were predictive of positive humoral vaccine response. In group 2 ( = 14), 6/14 patients (42.9%) had a positive antibody test after a second dose, 3/8 patients (37.5%) after a third dose, and 3/4 patients after a fourth dose. A third dose led to seroconversion in 1/8 patients (12.5%), while a fourth dose did so in 3/4 patients. : Additional vaccine doses increased seroconversion rates whilst high B-cell counts and low CAR-T-cell copy numbers were associated with positive antibody response.
由于CAR-T细胞治疗后出现B细胞发育不全，患者有发生严重SARS-CoV-2病程的风险。通过针对SARS-CoV-2刺突蛋白（抗S1/S2）的IgG抗体检测评估了COVID-19疫苗。接种程序：第1组：CAR-T细胞治疗后接种两至四剂疫苗；第2组：在CAR-T细胞治疗前接种两剂疫苗，随后接种第3或第4剂。在第1组（n = 32）中，7/30例患者（23.2%）在接种第二剂后抗体检测呈阳性，9/23例（39.1%）在接种第三剂后呈阳性，3/3例患者在接种第四剂后呈阳性。在有可用数据的21例患者中，第三剂导致5例（23.8%）发生血清转化，而第四剂导致2/3例患者发生血清转化。较高的B细胞（AUC：96.2%，CI：89 - 100，P = 0.0006）和较低的CAR-T细胞拷贝数（AUC：77.3%，CI：57 - 97，P = 0.0438）可预测体液疫苗反应阳性。在第2组（n = 14）中，6/14例患者（42.9%）在接种第二剂后抗体检测呈阳性，3/8例（37.5%）在接种第三剂后呈阳性，3/4例患者在接种第四剂后呈阳性。第三剂导致1/8例患者（12.5%）发生血清转化，而第四剂导致3/4例患者发生血清转化。额外的疫苗剂量提高了血清转化率，而高B细胞计数和低CAR-T细胞拷贝数与抗体反应阳性相关。
