在异性HSCT患者中重新接种SARS-CoV-2疫苗:重复的初级疫苗剂量增加了血清转化率
Marios Tsoutsoukis1,2, Chloe Anthias1, Sandra Easdale1
1The Royal Marsden NHS Hospital, Sutton, UK.
British journal of haematology
|September 24, 2024
概括
在血造干细胞移植 (HSCT) 后的患者中,第二剂COVID-19疫苗的抗体反应在第二剂后得到改善. 建议早期重新接种疫苗和增强剂,因为急性GVHD和rituximab治疗会影响疫苗的疗效.
科学领域:
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
- 疫苗学 疫苗学 疫苗学
背景情况:
- 患有血液性恶性瘤的患者的疫苗反应有所减少.
- 全基性造血干细胞移植 (HSCT) 进一步损害了抗体的产生.
- 关于在HSCT后患者中COVID-19疫苗疗效的数据有限.
研究的目的:
- 评估HSCT后患者对COVID-19疫苗的血清反应.
- 为了确定影响疫苗有效性的因素,在这个脆弱的人群中.
- 为了评估疫苗接种后HSCT患者中COVID-19的发病率和结果.
主要方法:
- 75名HSCT后患者的回顾性分析.
- 对Pfizer-BioNTech,AstraZeneca或Moderna疫苗 (1-4剂量) 的血清反应的评估.
- 分析因素,包括移植后的时间,GVHD和rituximab治疗.
主要成果:
- 随着疫苗剂量增加,血清转化率有所增加:50.7% (第一个),78% (第二个),79% (第三个),83% (第四个).
- 在12个月内,急性GVHD和rituximab治疗与初级疫苗不响应有关.
- 移植前的疫苗接种与更好的移植后抗体反应相关.
结论:
- 在HSCT后的额外剂量后,COVID-19疫苗抗体反应得到改善.
- 早期和完整的再接种计划对于减轻死亡率至关重要.
- 活性GVHD和rituximab是导致疫苗反应不佳的重要危险因素.
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