Asimakopoulos John V, Lalou Eleni, Seferlis George, Malliarou Maria, Konstantinou Eliana, Drandakis Ioannis, Vasilopoulos Ioannis, Georgopoulou Angeliki N, Kopsaftopoulou Anastasia, Machairas Alexandros, Piperidou Alexia, Karapaschalidis Anestis, Lefaki Maria-Ekaterini, Galopoulos Dimitrios, Arapaki Maria-Panagiota, Petsa Panagiota, Benekou Ekaterini, Siakantaris Marina P, Papavassiliou Athanasios G, Tsaftaridis Panagiotis, Panayiotidis Panayiotis, Vassilakopoulos Theodoros P, Papapanagiotou Angeliki, Angelopoulou Maria K
Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece.
Department of Biological Chemistry, National and Kapodistrian University of Athens, Biochemistry Laboratory, Laikon General Hospital, Aghiou Thoma 17 str, 11527 Athens, Attica, Greece.
Hematol Rep. 2024 Apr 16;16(2):220-233. doi: 10.3390/hematolrep16020022.
Data on antibody response (AR) after vaccination against SARS-CoV2 in hematopoietic stem-cell transplantation setting (HSCT) were initially scarce, mainly due to the exclusion of such patients from approval studies. Shortly after the worldwide application of vaccination against SARS-CoV-2 in vulnerable populations such as patients with hematologic malignancies, limited single-center trials, including HSCT patients, were published. However, there was a great heterogeneity between them regarding the type of underlying malignancy, co-current treatment, type of vaccine, method of AR measurement, and time point of AR measurement. Herein, we present the results of a prospective study on AR after vaccination for SARS-CoV-2 using the BNT162b2 vaccine in a cohort of 54 HSCT recipients-mostly autologous from a single Unit-along with a broad review of the current literature. In our cohort, the AR positivity rate at 1 month was 80.8% and remained positive in 85.7% of patients at 3 months after vaccination. There were only nine non-responders, who were more heavily pretreated and more frequently hypogammaglobulinemic compared to responders. High antibody titers (AT), [AT ≥ 1000 U/mL], were detected in 38.5% and 30.6% of the patients at m and m, respectively. A significant decline in AT between m and m was demonstrated- < 0.0001; median AT and AT were 480.5 and 293 U/mL, respectively. A novel finding of our study was the negative impact of IgA hypogammaglobulinemia on response to vaccination. Other negative significant factors were treatment with anti-CD20 antibody at vaccination and vaccination within 18 months from HSCT. Our data indicate that HSCT recipients elicit a positive response to the BNT162b2 vaccine against SARS-CoV-2 when vaccinated at 6 months post-transplant, and vaccination should be offered to this patient population even within the post-pandemic COVID-19 era.
造血干细胞移植（HSCT）背景下接种严重急性呼吸综合征冠状病毒2（SARS-CoV2）疫苗后的抗体反应（AR）数据最初很稀少，主要是因为此类患者被排除在获批研究之外。在针对血液系统恶性肿瘤患者等弱势群体全球接种SARS-CoV2疫苗后不久，包括HSCT患者在内的有限的单中心试验发表了。然而，它们在潜在恶性肿瘤类型、同期治疗、疫苗类型、AR测量方法以及AR测量时间点方面存在很大异质性。在此，我们展示了一项针对54名HSCT受者（大多为来自单一单位的自体移植受者）队列使用BNT162b2疫苗接种SARS-CoV2后AR的前瞻性研究结果，并对当前文献进行了广泛综述。在我们的队列中，1个月时AR阳性率为80.8%，接种疫苗3个月后85.7%的患者仍为阳性。只有9名无反应者，与反应者相比，他们接受的预处理更重，低丙种球蛋白血症更频繁。分别在第m个月和第m个月，38.5%和30.6%的患者检测到高抗体滴度（AT），[AT≥1000 U/mL]。第m个月和第m个月之间AT有显著下降 - <0.0001；AT中位数和AT分别为480.5和293 U/mL。我们研究的一个新发现是IgA低丙种球蛋白血症对疫苗接种反应有负面影响。其他负面显著因素是接种疫苗时使用抗CD20抗体治疗以及HSCT后18个月内接种疫苗。我们的数据表明，HSCT受者在移植后6个月接种时对针对SARS-CoV2的BNT162b2疫苗产生阳性反应，即使在新冠疫情后时代，也应向该患者群体提供疫苗接种。
Transplant Cell Ther. 2022-4
J Hematol Oncol. 2022-3-18
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