Mastronuzzi Angela, Carsetti Rita, De Ioris Maria Antonietta, Agrati Chiara, Del Baldo Giada, Russo Cristina, Cefalo Maria Giuseppina, Merli Pietro, Perno Carlo Federico, dell'Anna Vito Andrea, Serra Annalisa, Bordoni Veronica, Piano Mortari Eva, Marcellini Valentina, Albano Christian, Linardos Giulia, Costabile Valentino, Sinibaldi Matilde, Guercio Marika, di Cecca Stefano, Quintarelli Concetta, Locatelli Franco
Department of Pediatric Haematology and Oncology, and Cell and Gene Therapy Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
B cell Unit, Immunology Research Area, IRCCS Bambino Gesù Children's Hospital, Rome, Italy.
Heliyon. 2024 Jul 11;10(14):e34503. doi: 10.1016/j.heliyon.2024.e34503. eCollection 2024 Jul 30.
Immunocompromised children are at risk of developing severe COVID-19 infection. We conducted a pilot prospective study to evaluate the impact of cancer treatment and stem cell transplantation on immunogenicity of two doses of BNT162b2 vaccine in pediatric patients. Humoral, B- and T-cell responses to the BNT162b2 vaccine were assessed before, after the first and the second dose in patients aged 5-12 years (n = 35) and in a group of healthy donors (HD, n = 12). Patients were divided in three groups: solid tumors (ST, n = 11), hematological malignancies (HM, n = 14) and Hematopoietic Stem Cell Transplantation (HSCT) recipients (n = 10). After two vaccine doses, the seroconversion rate was 79.3 % (72.7 % in ST, 66.7 % in HM and 100 % in HSCT). The antibodies production was not associated to the presence of memory B and T-cells. Memory B-cells were measurable in 45.5 % ST, 66.6 % HSCT and in 22.0 % HM. The specific T-cell response was observed in most ST (81.8 %) and HSCT (85.7 %) patients and at lesser extent in those with HM (55.5 %). The combination of all immunological parameters (antibodies, memory B and T cells) showed that a significant fraction of HM (33.3 %) and ST (18.2 %) patients completely failed to respond to vaccination. Although able to produce antibodies, 11.1 % of HM and 27.3 % of ST had no B- and T-cell memory. HSCT subgroup showed the best immune function, with 80 % complete response and optimal T-cell function. Combination of anti-RBD antibody, and specific memory B- and T-cell responses represents a reliable read-out of vaccine immune efficacy in frail patients.
免疫功能低下的儿童有发生重症 COVID-19 感染的风险。我们开展了一项前瞻性试点研究，以评估癌症治疗和干细胞移植对两剂 BNT162b2 疫苗在儿科患者中的免疫原性的影响。在 5-12 岁患者（n = 35）和一组健康供者（HD，n = 12）中，于第一剂和第二剂之前、之后评估对 BNT162b2 疫苗的体液免疫、B 细胞和 T 细胞反应。患者分为三组：实体瘤（ST，n = 11）、血液系统恶性肿瘤（HM，n = 14）和造血干细胞移植（HSCT）受者（n = 10）。两剂疫苗接种后，血清转化率为 79.3%（ST 组为 72.7%，HM 组为 66.7%，HSCT 组为 100%）。抗体产生与记忆 B 细胞和 T 细胞的存在无关。在 45.5%的 ST 患者、66.6%的 HSCT 患者和 22.0%的 HM 患者中可检测到记忆 B 细胞。在大多数 ST 患者（81.8%）和 HSCT 患者（85.7%）中观察到特异性 T 细胞反应，而在 HM 患者中观察到的比例较低（55.5%）。所有免疫参数（抗体、记忆 B 细胞和 T 细胞）的综合分析表明，相当一部分 HM 患者（33.3%）和 ST 患者（18.2%）对疫苗接种完全无反应。尽管能够产生抗体，但 11.1%的 HM 患者和 27.3%的 ST 患者没有 B 细胞和 T 细胞记忆。HSCT 亚组显示出最佳的免疫功能，完全反应率为 80%，T 细胞功能最佳。抗 RBD 抗体与特异性记忆 B 细胞和 T 细胞反应的组合代表了虚弱患者疫苗免疫效果的可靠指标。
