Humoral serological response to the BNT162b2 vaccine is abrogated in lymphoma patients within the first 12 months following treatment with anti-CD2O antibodies.
Humoral serological response to the BNT162b2 vaccine is abrogated in lymphoma patients within the first 12 months following treatment with anti-CD2O antibodies.
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DOI：
10.3324/haematol.2021.279216
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发表时间：
2022-03-01
期刊：
影响因子：
10.1
通讯作者：
Horowitz NA
中科院分区：
文献类型：
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作者：
Gurion R;Rozovski U;Itchaki G;Gafter-Gvili A;Leibovitch C;Raanani P;Ben-Zvi H;Szwarcwort M;Taylor-Abigadol M;Dann EJ;Horesh N;Inbar T;Tzoran I;Lavi N;Fineman R;Ringelstein-Harlev S;Horowitz NA
淋巴瘤患者，特别是接受抗cd20单克隆抗体治疗的患者，与covid -19相关的发病率和死亡率很高。本研究的目的是评估两次注射辉瑞公司BNT162b2疫苗后淋巴瘤患者产生足够体液应答的能力，并确定影响应答的因素。采用SARS-CoV-2 IgG II Quant （Abbott©）法检测淋巴瘤患者接种第二剂疫苗后4±2周的血液样本的抗体滴度。阳性反应的截止值设为50 AU/mL。在这项横断面研究中，162名患者中有51%的患者血清学反应阳性。在多变量分析中，最后一次抗cd20单克隆抗体剂量与第二次疫苗剂量之间的间隔<12个月（优势比=31.3[95%置信区间：8.4-116.9]，P<0.001）和存在活动性淋巴瘤（优势比=4.2(95%置信区间：2.1-8.2)，P=0.006）被确定为阴性反应预测因子。在最后一次单克隆抗体注射后45天内接种疫苗的患者血清阳性率从3%上升到治疗后1年接种bbb10的患者血清阳性率的80%。后者的百分比与从未接触过单克隆抗体的患者相同。总之，淋巴瘤患者，特别是最近接受抗CD20单克隆抗体治疗的患者，对BNT162b2疫苗没有产生足够的体液应答。虽然血清学反应不是免疫的唯一预测因素，但其低水平可能使这一人群更容易感染COVID-19，这意味着需要为这类患者制定不同的疫苗接种计划。
Patients with lymphoma, especially those treated with anti-CD20 monoclonal antibodies, suffer high COVID-19-associated morbidity and mortality. The goal of this study was to assess the ability of lymphoma patients to generate a sufficient humoral response after two injections of BNT162b2 Pfizer vaccine and to identify factors influencing the response. Antibody titers were measured with the SARS-CoV-2 IgG II Quant (Abbott©) assay in blood samples drawn from lymphoma patients 4±2 weeks after the second dose of vaccine. The cutoff for a positive response was set at 50 AU/mL. Positive serological responses were observed in 51% of the 162 patients enrolled in this cross-sectional study. In a multivariate analysis, an interval of <12 months between the last anti-CD20 monoclonal antibody dose and the second vaccine dose (odds ratio=31.3 [95% confidence interval: 8.4-116.9], P<0.001) and presence of active lymphoma (odds ratio=4.2 (95% confidence interval: 2.1-8.2), P=0.006) were identified as negative response predictors. The rate of seropositivity increased from 3% in patients vaccinated within 45 days after the last monoclonal antibody administration to 80% in patients vaccinated >1 year after this therapy. The latter percentage was equal to that of patients never exposed to monoclonal antibodies. In conclusion, lymphoma patients, especially those recently treated with anti- CD20 monoclonal antibodies, fail to develop sufficient humoral response to BNT162b2 vaccine. While a serological response is not the only predictor of immunity, its low level could make this population more vulnerable to COVID-19, which implies the need for a different vaccination schedule for such patients.