Diminished humoral and cellular responses to SARS-CoV-2 vaccines in patients with chronic lymphocytic leukemia.
Diminished humoral and cellular responses to SARS-CoV-2 vaccines in patients with chronic lymphocytic leukemia.
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DOI：
10.1182/bloodadvances.2022009164
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发表时间：
2023-09-12
期刊：
影响因子：
7.5
通讯作者：
Thompson PA
中科院分区：
文献类型：
--
作者：
Ujjani C;Gooley TA;Spurgeon SE;Stephens DM;Lai C;Broome CM;O'Brien S;Zhu H;Laing KJ;Winter AM;Pongas G;Greninger AL;Koelle DM;Siddiqi T;Davids MS;Rogers KA;Danilov AV;Sperling A;Tu B;Sorensen T;Launchbury K;Burrow CJ;Quezada G;Hill JA;Shadman M;Thompson PA
接受B细胞定向疗法（包括BTK和BCL2抑制剂）的慢性淋巴细胞白血病（CLL）患者接种新冠疫苗后血清转化的可能性较低。
在武汉毒株中，观察到血清学反应和CD4 T细胞反应之间呈正相关。
先前的研究表明，慢性淋巴细胞白血病患者对严重急性呼吸综合征冠状病毒2（SARS - CoV - 2）信使核糖核酸（mRNA）疫苗的血清转化率较低。在美国11个癌症中心的全国合作项目中，我们旨在进一步描述和了解疫苗诱导的免疫反应，包括T细胞反应，以及CLL治疗药物的影响（#NCT04852822）。符合条件的患者被纳入2个队列：（1）初次接种疫苗时；（2）加强接种疫苗时。初次接种队列的210名患者和加强接种队列的117名患者的血清学反应率（抗S）分别为56%（95%置信区间[CI]，50 - 63）和68%（95% CI，60 - 77）。与未接受治疗的患者相比，接受B细胞定向疗法的患者血清转化的可能性更低（优势比[OR]，0.27；95% CI，0.15 - 0.49）。在6个月时观察到反应的持续性；抗S滴度随着加强接种而增加。在初次接种队列中，对于武汉毒株，定量血清学反应和CD4 T细胞反应之间观察到正相关，对于奥密克戎毒株也有一定程度的正相关（斯皮尔曼相关系数P = 0.45武汉；P = 0.25奥密克戎）。在加强接种队列中，对于两种毒株，血清学反应和CD4 T细胞反应之间都观察到正相关（P = 0.58武汉；P = 0.57奥密克戎），与CD8 T细胞反应也有一定程度的正相关（P = 0.33武汉；P = 0.22奥密克戎）。尽管在加强接种后尚未报告有因2019冠状病毒病（COVID - 19）导致的死亡，但随着新的毒株出现并逃避疫苗诱导的免疫，患者应谨慎。该试验在www.clinicaltrials.gov注册为#NCT04852822。
Patients with CLL receiving B-cell directed therapy, including BTK and BCL2 inhibitors, are less likely to seroconvert with COVID vaccines. Positive correlations were observed between serologic responses and CD4 T-cell responses in the Wuhan variant. Previous studies have demonstrated low rates of seroconversion to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines in patients with chronic lymphocytic leukemia (CLL). In this national collaboration of 11 cancer centers in the United States, we aimed to further characterize and understand vaccine-induced immune responses, including T-cell responses, and the impact of CLL therapeutics (#NCT04852822). Eligible patients were enrolled in 2 cohorts (1) at the time of initial vaccination and (2) at the time of booster vaccination. The serologic response rates (anti-S) from 210 patients in the initial vaccination cohort and 117 in the booster vaccination cohort were 56% (95% confidence interval [CI], 50-63) and 68% (95% CI, 60-77), respectively. Compared with patients not on therapy, those receiving B-cell-directed therapy were less likely to seroconvert (odds ratio [OR], 0.27; 95% CI, 0.15-0.49). Persistence of response was observed at 6 months; anti-S titers increased with the administration of booster vaccinations. In the initial vaccination cohort, positive correlations were observed between the quantitative serologic response and CD4 T-cell response for the Wuhan variant and, to a lesser degree, for the Omicron variant (Spearman P = 0.45 Wuhan; P = 0.25 Omicron). In the booster vaccination cohort, positive correlations were observed between serologic responses and CD4 T-cell responses for both variants (P = 0.58 Wuhan; P = 0.57 Omicron) and to a lesser degree for CD8 T-cell responses (P = 0.33 Wuhan; P = 0.22 Omicron). Although no deaths from coronavirus disease 2019 (COVID-19) have been reported after booster vaccinations, patients should use caution as newer variants emerge and escape vaccine-induced immunity. This trial was registered at www.clinicaltrials.gov as #NCT04852822.
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影响因子：
64.5
作者：
Sette A;Crotty S
通讯作者：
Crotty S
影响因子：
7.5
作者：
Pleyer C;Laing KJ;Ali MA;McClurkan CL;Soto S;Ahn IE;Nierman P;Maddux E;Lotter J;Superata J;Tian X;Wiestner A;Cohen JI;Koelle DM;Sun C
通讯作者：
Sun C
影响因子：
11.1
作者：
Tada, Takuya;Zhou, Hao;Dcosta, Belinda M.;Samanovic, Marie I.;Chivukula, Vidya;Herati, Ramin S.;Hubbard, Stevan R.;Mulligan, Mark J.;Landau, Nathaniel R.
通讯作者：
Landau, Nathaniel R.
影响因子：
20.3
作者：
Herishanu Y;Avivi I;Aharon A;Shefer G;Levi S;Bronstein Y;Morales M;Ziv T;Shorer Arbel Y;Scarfò L;Joffe E;Perry C;Ghia P
通讯作者：
Ghia P
影响因子：
7.5
作者：
Lyski ZL;Kim MS;Xthona Lee D;Raué HP;Raghunathan V;Griffin J;Ryan D;Brunton AE;Curlin ME;Slifka MK;Messer WB;Spurgeon SE
通讯作者：
Spurgeon SE