Autore Francesco, Stirparo Luca, Innocenti Idanna, Papa Elena, Marchesi Francesco, Togni Chiara, Mariani Sabrina, Torrieri Lorenzo, Salvatori Martina, Fazio Francesca, Metafuni Elisabetta, Giammarco Sabrina, Sora Federica, Falcucci Paolo, Ferrari Antonella, Trisolini Silvia Maria, Capria Saveria, Tafuri Agostino, Chiusolo Patrizia, Sica Simona, Laurenti Luca
Dipartimento di Diagnostica per Immagini Radioterapia Oncologica ed Ematologia Fondazione Policlinico, Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.
Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy.
Front Oncol. 2022 Dec 2;12:897937. doi: 10.3389/fonc.2022.897937. eCollection 2022.
COVID-19 disease has a strong impact on hematological patients; those receiving autologous hematopoietic stem cell transplantation (aHSCT) represent a particularly vulnerable group, in which the effectiveness of vaccination is very variable. Chiarucci et al. showed that patients affected by non-Hodgkin lymphoma (NHL) and treated with rituximab experienced a lower rate of immunization against SARS-CoV-2 (54%), as well as significantly lower IgG antibody titers. In our multicenter retrospective observational study, we included 82 patients who underwent aHSCT, divided into two groups: 58 patients vaccinated after aHSCT (group A) and 24 vaccinated before getting transplantation (group B). In group A, 39 (67%) patients had positive serology, and the rate of positivity increased with time after aHSCT. In the subgroup of patients with NHL, the administration of rituximab predicted negative serology, particularly when administered in the 6 months before vaccination (13% response rate). Patients affected by plasma cells had a higher rate of positivity (83% overall), independently of the time to aHSCT. In group B, no patient who initially showed positive serology became negative after transplantation, so the aHSCT did not affect the response to the vaccination. Our study confirmed the role of rituximab as a negative predictor of response to SARS-CoV-2 vaccination, whereas the conditioning and transplantation procedure itself seemed to be less important.
新冠病毒疾病对血液学患者有强烈影响;接受自体造血干细胞移植(aHSCT)的患者是特别脆弱的群体,其中疫苗接种的效果差异很大。基亚鲁奇等人表明,患有非霍奇金淋巴瘤(NHL)并接受利妥昔单抗治疗的患者,针对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的免疫接种率较低(54%),且免疫球蛋白G(IgG)抗体滴度也显著较低。在我们的多中心回顾性观察研究中,我们纳入了82例行aHSCT的患者,分为两组:58例在aHSCT后接种疫苗(A组)和24例在移植前接种疫苗(B组)。在A组中,39例(67%)患者血清学呈阳性,且阳性率随aHSCT后的时间增加。在NHL患者亚组中,利妥昔单抗的使用预示血清学呈阴性,尤其是在接种疫苗前6个月使用时(应答率为13%)。浆细胞疾病患者的阳性率较高(总体为83%),与至aHSCT的时间无关。在B组中,最初血清学呈阳性的患者在移植后无一例转为阴性,因此aHSCT似乎不影响对疫苗接种的应答。我们的研究证实了利妥昔单抗是SARS-CoV-2疫苗接种应答的阴性预测指标,而预处理和移植程序本身似乎不太重要。
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