Rinaldi Ikhwan, Pratama Samuel, Wiyono Lowilius, Tandaju Jeremy Rafael, Wardhana Indy Larasati, Winston Kevin
Hematology and Medical Oncology Division, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
Front Oncol. 2022 Aug 5;12:951215. doi: 10.3389/fonc.2022.951215. eCollection 2022.
Patient populations, including those with hematological malignancies, have different responses to COVID-19 vaccines. This study aimed to quantitatively analyze the efficacy and safety of COVID-19 mRNA vaccines in patients with hematological malignancies. Studies reporting on the efficacy and safety of COVID-19 mRNA vaccines in cohorts with hematological malignancies compared to healthy controls were systematically searched in four databases. Meta-analysis and subgroup analyses were performed to generate quantitative synthesis. Fifteen studies with 2,055 cohorts with hematological malignancies and 1,105 healthy subjects as control were included. After two doses of COVID-19 vaccination, only 60% of cohorts with hematological malignancies were seroconverted compared to healthy controls (RR 0.60; 95%CI 0.50-0.71). A single dose of the vaccine resulted in a significantly lower seroconversion rate (RR 0.30; 95%CI 0.16-0.54). Non-Hodgkin lymphoma cohorts had the lowest rate of seroconversion (RR 0.5; 95%CI 0.35-0.71) and those who received active treatments had lower immunological responses (RR 0.59; 95%CI 0.46-0.75). Antibody titers were lower in cohorts with hematological malignancies without any differences in adverse effects in both groups. In conclusion, cohorts with hematological malignancies showed a lower seroconversion rate and antibody titers after receiving COVID-19 mRNA vaccines. The type of malignancy and the status of treatment had a significant impact on the response to vaccination. The vaccines were shown to be safe for both patients with hematological malignancies and healthy controls. Booster doses and stricter health protocols might be beneficial for patient populations.
包括血液系统恶性肿瘤患者在内的不同患者群体对新冠病毒疫苗有不同反应。本研究旨在定量分析新冠病毒信使核糖核酸（mRNA）疫苗在血液系统恶性肿瘤患者中的疗效和安全性。在四个数据库中系统检索了关于新冠病毒mRNA疫苗在血液系统恶性肿瘤队列与健康对照相比的疗效和安全性的研究。进行荟萃分析和亚组分析以进行定量综合。纳入了15项研究，其中有2055个血液系统恶性肿瘤队列和1105名健康受试者作为对照。接种两剂新冠病毒疫苗后，与健康对照相比，只有60%的血液系统恶性肿瘤队列出现血清转化（相对风险0.60；95%置信区间0.50 - 0.71）。单剂疫苗导致血清转化率显著降低（相对风险0.30；95%置信区间0.16 - 0.54）。非霍奇金淋巴瘤队列的血清转化率最低（相对风险0.5；95%置信区间0.35 - 0.71），接受积极治疗的患者免疫反应较低（相对风险0.59；9%置信区间0.46 - 0.75）。血液系统恶性肿瘤队列的抗体滴度较低，两组在不良反应方面无差异。总之，血液系统恶性肿瘤队列在接种新冠病毒mRNA疫苗后血清转化率和抗体滴度较低。恶性肿瘤类型和治疗状态对疫苗接种反应有显著影响。这些疫苗对血液系统恶性肿瘤患者和健康对照均显示出安全性。加强剂量和更严格的健康方案可能对患者群体有益。
