Blood Disorders Center, Aiiku Hospital, Sapporo, Japan.
Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan.
Cancer Med. 2023 Aug;12(16):16881-16888. doi: 10.1002/cam4.6314. Epub 2023 Jul 6.
We have reported that seroconversion rates after the second dose of mRNA-based COVID-19 vaccines for myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) were 100% and 95% respectively, with no significant difference from healthy controls (HCs).However, there are very limited data for the response to a third vaccine dose in those patients.
In this complementary study, we investigated the booster effect of a third mRNA-based COVID-19 vaccine dose in patients with myeloid malignancies.
MATERIALS & METHODS: A total 58 patients including 20 patients with MDS and 38 patients with AML were enrolled. Anti-SARS-CoV-2S immunoassays were performed at 3, 6, and 9 months after the second vaccine dose.
Seventy-five percent of the MDS patients and 37% of the AML patients were receiving active treatment at the time of the third vaccination. Both the initial and third vaccine response in AML patients were comparable to those in HCs. In MDS patients, although the initial vaccine immunogenicity was inferior to that in HCs and AML patients, the third vaccine improved the response to a level not inferior to those in HCs and AML patients. Of note, the third vaccine resulted in a significant increase of antibodies in actively treated MDS patients who had shown a response inferior to that in untreated patients after two doses of vaccination.
In patients with myeloid malignancies, the third vaccine dose showed a booster effect, and disease- and therapy-related factors associated with the booster response have been identified.
The third dose of an mRNA-based COVID-19 vaccine showed a booster effect in patients with myeloid malignancies. Such a good booster response has not been reported in other haematological malignancies.
我们曾报道，骨髓增生异常综合征（MDS）和急性髓系白血病（AML）患者接种第二剂 mRNA 新冠疫苗后的血清转换率分别为 100%和 95%，与健康对照（HC）无显著差异。然而，这些患者接种第三剂疫苗后的反应数据非常有限。
在这项补充研究中，我们调查了第三剂 mRNA 新冠疫苗在骨髓恶性肿瘤患者中的增强效果。
共纳入 58 例患者，其中 MDS 患者 20 例，AML 患者 38 例。在接种第二剂疫苗后 3、6 和 9 个月进行抗 SARS-CoV-2S 免疫测定。
75%的 MDS 患者和 37%的 AML 患者在第三次接种时正在接受积极治疗。AML 患者的初始和第三次疫苗反应与 HC 相似。在 MDS 患者中，尽管初始疫苗免疫原性低于 HC 和 AML 患者，但第三次疫苗接种提高了反应水平，与 HC 和 AML 患者相当。值得注意的是，与两剂疫苗接种后反应低于未治疗患者的 MDS 患者相比，第三次疫苗接种使正在接受积极治疗的 MDS 患者的抗体显著增加。
在骨髓恶性肿瘤患者中，第三剂疫苗显示出增强效果，并确定了与增强反应相关的疾病和治疗相关因素。
mRNA 新冠疫苗的第三剂在骨髓恶性肿瘤患者中显示出增强效果。在其他血液恶性肿瘤中尚未报道过如此良好的增强反应。
