Angelidakis Georgios, Chemaly Roy F, Sahasrabhojane Pranoti V, Morado-Aramburo Oscar, Jiang Ying, Bhatti Micah M, Shpall Elizabeth, Hosing Chitra, Jain Preetesh, Mahadeo Kris Michael, Khawaja Fareed, Elhajj Peter, Wargo Jennifer A, Jenq Robert R, Ajami Nadim J, Kebriaei Partow, Ariza-Heredia Ella J
Departments of Infectious Diseases, Infection Control and Employee Health, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Vaccines (Basel). 2024 Sep 19;12(9):1070. doi: 10.3390/vaccines12091070.
Patients undergoing immune effector cell therapy (IECT) are at high risk for infections. We assessed seropositivity against pneumococcus, tetanus, and diphtheria in patients before and after IECT and the patients' response to vaccination. We enrolled patients who underwent IECT from January 2020 to March 2022. Antibody levels for diphtheria, tetanus, and pneumococcus were measured before IECT, at 1 month, and 3-6 months after. Eligible patients were vaccinated after IECT. In non-seroprotected patients, we discontinued testing. Before IECT, most patients had seroprotective antibody levels against tetanus (68/69, 99%) and diphtheria (65/69, 94%), but fewer did against pneumococcus (24/67, 36%). After IECT, all patients had seroprotective antibody levels for tetanus at 1 month (68/68) and 3-6 months (56/56). For diphtheria, 65/65 patients (100%) had seroprotective antibody levels at 1 month, and 48/53 (91%) did at 3-6 months. For pneumococcus, seroprotective antibody levels were identified in 91% (21/23) of patients at 1 month and 79% (15/19) at 3-6 months following IECT. Fifteen patients received a pneumococcal vaccine after IECT, but none achieved seroprotective response. One patient received the tetanus-diphtheria vaccine and had a seroprotective antibody response. Because some patients experience loss of immunity after IECT, studies evaluating vaccination strategies post-IECT are needed.
接受免疫效应细胞疗法（IECT）的患者感染风险很高。我们评估了IECT治疗前后患者针对肺炎球菌、破伤风和白喉的血清阳性率以及患者对疫苗接种的反应。我们纳入了2020年1月至2022年3月接受IECT治疗的患者。在IECT治疗前、治疗后1个月以及治疗后3 - 6个月测量白喉、破伤风和肺炎球菌的抗体水平。符合条件的患者在IECT治疗后接种疫苗。对于未获得血清保护的患者，我们停止检测。在IECT治疗前，大多数患者针对破伤风（68/69，99%）和白喉（65/69，94%）具有血清保护性抗体水平，但针对肺炎球菌的较少（24/67，36%）。IECT治疗后，所有患者在1个月时针对破伤风的血清保护性抗体水平均为68/68，在3 - 6个月时为56/56。对于白喉，65/65名患者（100%）在1个月时具有血清保护性抗体水平，在3 - 6个月时48/53名患者（91%）具有该水平。对于肺炎球菌，在IECT治疗后1个月，91%（21/23）的患者具有血清保护性抗体水平，在3 - 6个月时79%（15/19）的患者具有该水平。15名患者在IECT治疗后接种了肺炎球菌疫苗，但均未获得血清保护性反应。1名患者接种了破伤风 - 白喉疫苗并产生了血清保护性抗体反应。由于一些患者在IECT治疗后会出现免疫力丧失，因此需要开展评估IECT治疗后疫苗接种策略的研究。
