Montella Liliana, Dell'Aversana Carmela, Pacella Daniela, Troise Simona, Russo Paola, Cacciapuoti Valentina, Ottaiano Alessandro, Di Marino Luigi, Coppola Paola, Liguori Carmela, Berretta Massimiliano, Maddaluno Salvatore, Altucci Lucia, Facchini Gaetano
Oncology Operative Unit, "Santa Maria delle Grazie" Hospital, Pozzuoli, Napoli, ASL NA2 NORD 80078, Italy.
Institute Experimental Endocrinology and Oncology "Gaetano Salvatore" (IEOS)- CNR IT, Naples, Italy.
Infect Agent Cancer. 2023 Oct 17;18(1):62. doi: 10.1186/s13027-023-00532-9.
SARS-CoV-2 vaccination is strongly recommended, particularly for fragile patients such as those undergoing active oncological treatments. It is crucial to conduct post-marketing surveillance in this patient population. In our study, we conducted a retrospective analysis of real-world data, including 136 patients who received SARS-CoV-2 vaccines and were undergoing anticancer treatments between March 1st and June 30th, 2021. All patients received mRNA vaccines, namely Pfizer-BioNTech's COMIRNATY (BNT162b2 mRNA) and Moderna's mRNA-1273 COVID-19 vaccines. We collected blood samples from the patients one week to 10 days before and after vaccine administration to assess full blood count with white cell differentials. Additionally, we monitored serology titers to detect any previous SARS-CoV-2 infection before hospital admission and tracked changes over time. Our findings revealed a significant occurrence of leukopenia following both the first and second vaccine doses among patients receiving chemotherapy and chemo-immunotherapy. Importantly, this effect was independent of demographic factors such as sex, age, and Body Mass Index. In the chemo-immunotherapy treated group, we observed that concomitant immune-mediated diseases were significantly associated with leukopenia following the second vaccine dose. Notably, in healthy subjects, transient neutropenia was recognized as an adverse event following vaccination. The observed lymphocytopenia during SARS-CoV-2 infection, combined with the impact on leukocyte counts observed in our study, underscores the need for larger post-marketing surveillance studies. Despite a treatment delay occurring in 6.6% of patients, the administration of mRNA vaccines did not have a significant impact on the treatment schedule in our series. These findings from a real-world setting provide valuable insights and suggest avenues for further prospective studies to explore potential complex interactions specific to this patient population.
强烈建议接种新型冠状病毒2型（SARS-CoV-2）疫苗，尤其是对于正在接受积极肿瘤治疗等脆弱患者。对这一患者群体进行上市后监测至关重要。在我们的研究中，我们对真实世界数据进行了回顾性分析，包括136例在2021年3月1日至6月30日期间接受SARS-CoV-2疫苗接种并正在接受抗癌治疗的患者。所有患者均接种了mRNA疫苗，即辉瑞- BioNTech的Comirnaty（BNT162b2 mRNA）和莫德纳的mRNA-1273新冠疫苗。我们在疫苗接种前1周和接种后10天采集患者血液样本，以评估全血细胞计数及白细胞分类。此外，我们监测血清学滴度，以检测入院前是否有过SARS-CoV-2感染，并跟踪随时间的变化。我们的研究结果显示，接受化疗和化疗免疫治疗的患者在接种第一剂和第二剂疫苗后均出现了显著的白细胞减少。重要的是，这种效应与性别、年龄和体重指数等人口统计学因素无关。在化疗免疫治疗组中，我们观察到，伴随的免疫介导疾病与接种第二剂疫苗后的白细胞减少显著相关。值得注意的是，在健康受试者中，短暂性中性粒细胞减少被认为是接种疫苗后的不良事件。在SARS-CoV-2感染期间观察到的淋巴细胞减少，加上我们研究中观察到的对白细胞计数的影响，凸显了开展更大规模上市后监测研究必要性。尽管6.6%的患者出现了治疗延迟，但在我们的系列研究中，mRNA疫苗的接种对治疗计划没有显著影响。这些来自真实世界的研究结果提供了有价值的见解，并为进一步的前瞻性研究指明了方向，以探索这一患者群体特有的潜在复杂相互作用。
