Thompson Michael A, Hallmeyer Sigrun, Fitzpatrick Veronica E, Liao Yunqi, Mullane Michael P, Medlin Stephen C, Copeland Kenneth, Weese James L
Aurora Cancer Care, Advocate Aurora Health, Milwaukee, WI.
Hematology/Oncology, Advocate Aurora Health, Downers Grove, IL.
J Patient Cent Res Rev. 2022 Jul 18;9(3):149-157. doi: 10.17294/2330-0698.1952. eCollection 2022 Summer.
This study sought to describe the changes in immune response to a third dose of either Pfizer's or Moderna's COVID-19 mRNA vaccine (3V) among patients with hematologic malignancies, as well as associated characteristics.
This retrospective cohort study analyzed pre-3V and post-3V data on 493 patients diagnosed with hematologic malignancies across a large Midwestern health system between August 28, 2021, and November 1, 2021. For antibody testing, S1 spike antigen of the SARS-CoV-2 virus titer was used to determine serostatus.
Among 493 participants, 274 (55.6%) were seropositive both pre- and post-3V (+/+) while 115 (23.3%) seroconverted to positive from prior negative following the third dose (-/+). The remaining 104 (21.1%) were seronegative both before and after 3V (-/-). No participant was seropositive pre-3V and seronegative post-3V (+/-). Results showed a statistically significant increase in the proportion of seropositivity after receiving a third COVID-19 vaccine (P<0.00001). Response to 3V was significantly associated with the 3V vaccine type (P=0.0006), previous COVID-19 infection (P=0.0453), and malignancy diagnosis (P<0.0001). Likelihood of seroconversion (-/+) after 3V was higher in the group of patients with multiple myeloma or related disorders compared to patients with lymphoid leukemias (odds ratio: 8.22, 95% CI: 2.12-31.79; P=0.0008).
A third COVID-19 vaccination is effective in producing measurable seroconversion in many patients with hematologic malignancies. Oncologists should actively encourage all their patients, especially those with multiple myeloma, to receive a 3V, given the high likelihood of seroconversion.
本研究旨在描述血液系统恶性肿瘤患者对辉瑞或莫德纳新冠mRNA疫苗第三剂（3V）的免疫反应变化以及相关特征。
这项回顾性队列研究分析了2021年8月28日至2021年11月1日期间，在中西部一个大型医疗系统中确诊为血液系统恶性肿瘤的493例患者在接种3V疫苗前和接种后的数据。对于抗体检测，使用SARS-CoV-2病毒滴度的S1刺突抗原确定血清状态。
在493名参与者中，274名（55.6%）在接种3V疫苗前后均为血清阳性（+/+），而115名（23.3%）在第三剂疫苗接种后从先前的阴性转为阳性（-/+）。其余104名（21.1%）在接种3V疫苗前后均为血清阴性（-/-）。没有参与者在接种3V疫苗前为血清阳性而接种后为血清阴性（+/-）。结果显示，接种第三剂新冠疫苗后血清阳性比例有统计学显著增加（P<0.00001）。对3V的反应与3V疫苗类型（P=0.0006）、先前的新冠病毒感染（P=0.0453）和恶性肿瘤诊断（P<0.0001）显著相关。与淋巴白血病患者相比，多发性骨髓瘤或相关疾病患者在接种3V疫苗后血清转化（-/+）的可能性更高（优势比：8.22，95%置信区间：2.12-31.79；P=0.0008）。
第三剂新冠疫苗接种对许多血液系统恶性肿瘤患者产生可测量的血清转化有效。鉴于血清转化的可能性很高，肿瘤学家应积极鼓励所有患者，尤其是多发性骨髓瘤患者接种3V疫苗。
