Regular Humoral and Cellular Immune Responses in Individuals with Chronic Myeloid Leukemia Who Received a Full Vaccination Schedule against COVID-19.
Regular Humoral and Cellular Immune Responses in Individuals with Chronic Myeloid Leukemia Who Received a Full Vaccination Schedule against COVID-19.
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DOI：
10.3390/cancers15205066
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发表时间：
2023-10-20
期刊：
影响因子：
5.2
通讯作者：
Garcia-Gutierrez, Valentin
中科院分区：
文献类型：
--
作者：
Rodriguez-Mora, Sara;Corona, Magdalena;Solera Sainero, Miriam;Mateos, Elena;Torres, Montserrat;Sanchez-Menendez, Clara;Casado-Fernandez, Guiomar;Garcia-Perez, Javier;Perez-Olmeda, Mayte;Murciano-Anton, Maria Aranzazu;Lopez-Jimenez, Javier;Coiras, Mayte;Garcia-Gutierrez, Valentin
关键词：
慢性粒细胞白血病（CML）患者与其他患有肿瘤性血液病（OHD）的患者不同，因为他们接受药物治疗，这些药物可能会调节免疫系统细胞的活性，导致其对癌细胞的活性增加。这种活性也可以有效对抗被病毒感染的细胞。虽然OHD患者通常对病毒感染的反应降低，但CML患者感染的风险较低。因此，我们假设CML患者在接种COVID-19疫苗后可能比其他OHD患者产生更好的反应。我们证实，在接种疫苗后，CML患者和健康献血者在形成抗SARS-CoV-2抗体方面没有差异，这些抗体具有中和病毒的能力。在细胞免疫方面，两组之间也观察到相似的结果。总之，CML患者在接种COVID-19疫苗后产生的免疫力与健康供体相当，尽管仍在接受癌症治疗的CML患者的免疫力优于因CML大幅改善而停止治疗的患者。尽管疫苗接种并没有完全阻止慢粒患者感染SARS-CoV-2，但它阻止了严重或危重疾病的发展。慢性粒细胞白血病（CML）是血液肿瘤性疾病（OHD）中的一个独特群体。他们接受具有免疫调节特性的酪氨酸激酶抑制剂（TKI）治疗，尽管疾病具有慢性性质，但在某些情况下，他们最终可能成为治疗中止的候选者。此外，这些人比其他免疫功能低下的患者感染的风险更低。在这项研究中，我们招募了29名处于深度分子应答的CML患者，他们正在接受TKI治疗（n = 23）或处于无治疗缓解（TFR）（n = 6），并在接受SARS-CoV-2完整疫苗接种计划后与20名健康供体比较体液和细胞免疫应答。所有参与者都被随访了17个月，以记录由于突破性感染而导致的COVID-19的发展。尽管存在高水平的未成熟B细胞，但所有CML患者的体液应答均增加，血清转化率和中和滴度与健康供体相似。总体而言，细胞免疫应答也与健康供体相当，尽管抗体依赖性细胞毒活性（ADCC）显著降低。两组间观察到轻度突破性感染的发生率相似，尽管接受TFR治疗的CML个体中的比例较高，最可能是由于这些药物的免疫调节作用。总之，与健康供体一样，疫苗接种并不能完全阻止CML患者的突破性感染，尽管它阻止了OHD患者这一特殊人群发生严重或危重疾病。
Individuals with chronic myeloid leukemia (CML) are different from other individuals with oncohematological disease (OHD) because they receive treatment with drugs that may modulate the activity of cells from the immune system, causing an increase in their activity against the cancerous cells. This activity may also be effective against cells infected with virus. Although people with OHD usually have a reduced response to viral infections, individuals with CML present low risk of infection. Therefore, we hypothesized that people with CML may develop a better response after vaccination against COVID-19 than other individuals with OHD. We confirmed that there was no difference between people with CML and healthy donors in the formation of antibodies against SARS-CoV-2 with capacity to neutralize the virus after receiving vaccination. Similar results were also observed between both groups in the cellular immunity. In conclusion, individuals with CML developed immunity that was comparable to healthy donors after COVID-19 vaccination, although it was better in people with CML who was still on treatment against their cancer disease than in those who had discontinued treatment due to great improvement in the CML. And although the vaccination did not impede completely infections with SARS-CoV-2 in individuals with CML, it prevented the development of severe or critical illness. Individuals with chronic myeloid leukemia (CML) constitute a unique group within individuals with oncohematological disease (OHD). They receive treatment with tyrosine kinase inhibitors (TKIs) that present immunomodulatory properties, and they may eventually be candidates for treatment discontinuation under certain conditions despite the chronic nature of the disease. In addition, these individuals present a lower risk of infection than other immunocompromised patients. For this study, we recruited a cohort of 29 individuals with CML in deep molecular response who were on treatment with TKIs (n = 23) or were on treatment-free remission (TFR) (n = 6), and compared both humoral and cellular immune responses with 20 healthy donors after receiving the complete vaccination schedule against SARS-CoV-2. All participants were followed up for 17 months to record the development of COVID-19 due to breakthrough infections. All CML individuals developed an increased humoral response, with similar seroconversion rates and neutralizing titers to healthy donors, despite the presence of high levels of immature B cells. On the whole, the cellular immune response was also comparable to that of healthy donors, although the antibody dependent cytotoxic activity (ADCC) was significantly reduced. Similar rates of mild breakthrough infections were observed between groups, although the proportion was higher in the CML individuals on TFR, most likely due to the immunomodulatory effect of these drugs. In conclusion, as with the healthy donors, the vaccination did not impede breakthrough infections completely in individuals with CML, although it prevented the development of severe or critical illness in this special population of individuals with OHD.
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DOI：
10.1056/nejmoa2119451
发表时间：
2022-04-21
期刊：
The New England journal of medicine
影响因子：
--
作者：
Andrews N;Stowe J;Kirsebom F;Toffa S;Rickeard T;Gallagher E;Gower C;Kall M;Groves N;O'Connell AM;Simons D;Blomquist PB;Zaidi A;Nash S;Iwani Binti Abdul Aziz N;Thelwall S;Dabrera G;Myers R;Amirthalingam G;Gharbia S;Barrett JC;Elson R;Ladhani SN;Ferguson N;Zambon M;Campbell CNJ;Brown K;Hopkins S;Chand M;Ramsay M;Lopez Bernal J
通讯作者：
Lopez Bernal J
影响因子：
7.3
作者：
Hughes A;Yong ASM
通讯作者：
Yong ASM
影响因子：
5.4
作者：
Rodríguez-Agustín A;Casanova V;Grau-Expósito J;Sánchez-Palomino S;Alcamí J;Climent N
通讯作者：
Climent N
IFNα对深层分子反应中慢性髓样白血病患者T和NK细胞的免疫调节作用为治疗中断准备。
影响因子：
3.9
作者：
Puzzolo, Maria Cristina;Breccia, Massimo;Mariglia, Paola;Colafigli, Gioia;Pepe, Sara;Scalzulli, Emilia;Mariggio, Elena;Latagliata, Roberto;Guarini, Anna;Foa, Robin
通讯作者：
Foa, Robin
影响因子：
7.8
作者：
Katagiri S;Akahane D;Otsuki S;Suto A;Yamada A;Suguro T;Asano M;Yoshizawa S;Tanaka Y;Furuya N;Fujimoto H;Okabe S;Gotoh M;Ito Y;Gotoh A
通讯作者：
Gotoh A