Vaccine response following anti-CD20 therapy: a systematic review and meta-analysis of 905 patients.
Vaccine response following anti-CD20 therapy: a systematic review and meta-analysis of 905 patients.
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DOI：
10.1182/bloodadvances.2021004629
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发表时间：
2021-06-21
期刊：
影响因子：
7.5
通讯作者：
Hicks LK
中科院分区：
文献类型：
--
作者：
Vijenthira A;Gong I;Betschel SD;Cheung M;Hicks LK
本研究的目的是对接受抗CD 20治疗的患者的疫苗反应性文献进行系统综述。检索了截至2021年1月4日的PubMed和EMBASE，以识别在接受抗CD 20治疗的患者（包括血液恶性肿瘤或自身免疫性疾病患者）中进行的疫苗免疫原性研究。主要结果是报告的每种疫苗的血清保护（SP）、血清转换（SC）和/或血清应答率。由于大流行性流感疫苗（2009 H1N1）对SP和SC的定义进行了标准化，并且代表了与COVID-19疫苗相似的新型主要抗原，因此对该疫苗研究的SC进行了荟萃分析。使用随机效应模型计算合并估计值、相对获益比（RB）和95%置信区间（CI）。纳入了38项研究（905例接受抗CD 20治疗的患者）（19项血液恶性肿瘤患者研究）。接受积极抗CD 20治疗（自末次给药后<3个月）的患者对所有类型疫苗的反应均较差。这些患者接种1剂大流行性流感疫苗后SC的合并估计值为3%（95% CI，0%-9%），与健康对照相比的RB为0.05（95% CI，0-0.73），与疾病对照相比的RB为0.22（95% CI，0.09-0.56）。与对照组相比，SC似乎在治疗后至少6个月内消除（抗CD 20治疗后3-6个月，与健康组相比RB为0.50 [95% CI，0.24-1.06]，与疾病对照组相比RB为0.44 [95% CI，0.23-0.84]）。对于所有类型的疫苗，对疫苗接种的反应随着时间的推移而逐渐改善，但即使在治疗后12个月也可能达不到健康对照的水平。
The objective of this study was to perform a systematic review of the literature on vaccine responsiveness in patients who have received anti-CD20 therapy. PubMed and EMBASE were searched up to 4 January 2021 to identify studies of vaccine immunogenicity in patients treated with anti-CD20 therapy, including patients with hematologic malignancy or autoimmune disease. The primary outcomes were seroprotection (SP), seroconversion (SC), and/or seroresponse rates for each type of vaccine reported. As the pandemic influenza vaccine (2009 H1N1) has standardized definitions for SP and SC, and represented a novel primary antigen similar to the COVID-19 vaccine, meta-analysis was conducted for SC of studies of this vaccine. Pooled estimates, relative benefit ratios (RBs), and 95% confidence intervals (CIs) were calculated using a random-effects model. Thirty-eight studies (905 patients treated with anti-CD20 therapy) were included (19 studies of patients with hematologic malignancies). Patients on active (<3 months since last dose) anti-CD20 therapy had poor responses to all types of vaccines. The pooled estimate for SC after 1 pandemic influenza vaccine dose in these patients was 3% (95% CI, 0% to 9%), with an RB of 0.05 (95% CI, 0-0.73) compared with healthy controls and 0.22 (95% CI, 0.09-0.56) compared with disease controls. SC compared with controls seems abrogated for at least 6 months following treatment (3-6 months post anti-CD20 therapy with an RB of 0.50 [95% CI, 0.24-1.06] compared with healthy and of 0.44 [95% CI, 0.23-0.84] compared with disease controls). For all vaccine types, response to vaccination improves incrementally over time, but may not reach the level of healthy controls even 12 months after therapy.
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影响因子：
6.3
作者：
Barendregt, Jan J.;Doi, Suhail A.;Vos, Theo
通讯作者：
Vos, Theo
DOI：
10.1056/nejmoa2035389
发表时间：
2021-02-04
期刊：
The New England journal of medicine
影响因子：
--
作者：
Baden LR;El Sahly HM;Essink B;Kotloff K;Frey S;Novak R;Diemert D;Spector SA;Rouphael N;Creech CB;McGettigan J;Khetan S;Segall N;Solis J;Brosz A;Fierro C;Schwartz H;Neuzil K;Corey L;Gilbert P;Janes H;Follmann D;Marovich M;Mascola J;Polakowski L;Ledgerwood J;Graham BS;Bennett H;Pajon R;Knightly C;Leav B;Deng W;Zhou H;Han S;Ivarsson M;Miller J;Zaks T;COVE Study Group
通讯作者：
COVE Study Group
影响因子：
9.1
作者：
Eisenberg RA;Jawad AF;Boyer J;Maurer K;McDonald K;Prak ET;Sullivan KE
通讯作者：
Sullivan KE
影响因子：
6.2
作者：
Cooksley, CD;Avritscher, EBC;Elting, LS
通讯作者：
Elting, LS
影响因子：
7.8
作者：
Avivi, Irit;Zisman-Rozen, Simona;Melamed, Doron
通讯作者：
Melamed, Doron