Department of Hematology, Daping Hospital, Army Medical University, No. 10, Daping Changjiang Branch Road, Yuzhong District, Chongqing, 400042, China.
BMC Immunol. 2024 Jan 13;25(1):5. doi: 10.1186/s12865-024-00596-1.
The ability of generating effective humoral immune responses to SARS-CoV-2 infection has not been clarified in lymphoma patients. The study aimed to investigate the antibody (Ab) production after SARS-Cov-2 infection and clarify the factors affecting the Ab generation in these patients.
PATIENTS & METHODS: 80 lymphoma patients and 51 healthy controls were included in this prospective observational study. Clinical factors and treatment regimens affecting Ab positive rate (APR) and Ab levels were analyzed by univariate and multivariate methods.
The anti-SARS-CoV-2 IgG APR and Ab levels in lymphoma patients were significantly lower than those in healthy controls. Lymphoma patients with COVID-19 vaccination had significantly higher APR and Ab levels compared with those without vaccination. Additionally, the use of dexamethasone for COVID-19 treatment had a negative impact on Ab levels. For the impact of treatment regimens on the APR and Ab levels, the results showed that patients treated with ≥ 6 times CD20 monoclonal Ab (mAb) and patients treated with autologous hematopoietic stem cell transplantation (ASCT) prior to infection produced a statistically lower APR and Ab levels compared with those treated with 1-5 times CD20 mAb and those treated without ASCT, respectively. Furthermore, multiple regression analysis indicated that the number of anti-CD20 treatment was an independent predictor for both APR and Ab levels.
Humoral immune response to SARS-CoV-2 infection was impaired in lymphoma patients partly due to anti-CD20 and ASCT treatment. COVID-19 vaccination may be more needed for these patients.
淋巴瘤患者对 SARS-CoV-2 感染产生有效体液免疫反应的能力尚未明确。本研究旨在调查 SARS-CoV-2 感染后的抗体(Ab)产生情况,并阐明这些患者中影响 Ab 产生的因素。
本前瞻性观察研究纳入了 80 例淋巴瘤患者和 51 名健康对照者。采用单变量和多变量方法分析了影响 Ab 阳性率(APR)和 Ab 水平的临床因素和治疗方案。
与健康对照组相比,淋巴瘤患者的抗 SARS-CoV-2 IgG APR 和 Ab 水平明显较低。接受 COVID-19 疫苗接种的淋巴瘤患者的 APR 和 Ab 水平明显高于未接种疫苗的患者。此外,地塞米松用于 COVID-19 治疗对 Ab 水平有负面影响。对于治疗方案对 APR 和 Ab 水平的影响,结果显示,与接受 1-5 次 CD20 单克隆抗体(mAb)治疗的患者和未接受 ASCT 治疗的患者相比,接受≥6 次 CD20 mAb 治疗的患者和感染前接受 ASCT 治疗的患者的 APR 和 Ab 水平明显较低。此外,多元回归分析表明,抗 CD20 治疗次数是 APR 和 Ab 水平的独立预测因素。
淋巴瘤患者对 SARS-CoV-2 感染的体液免疫反应受损,部分原因是抗 CD20 和 ASCT 治疗。这些患者可能更需要 COVID-19 疫苗接种。