慢性淋巴细胞白血病患者的SARS-CoV-2疫苗接种免疫反应动态:描述性分析
Clara Sánchez-Menéndez1,2,3, Alejandro Zurdo2, Magdalena Corona2
1Immunopathology and Viral Reservoir Unit, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain.
Frontiers in immunology
|June 23, 2025
概括
慢性淋巴细胞白血病 (CLL) 患者的COVID-19疫苗接种显示在接受治疗的人群中抗体反应减少. 观察和等待策略保留了B细胞水平,但活性疗法会影响疫苗的整体有效性.
科学领域:
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
- 在瘤学瘤学.
背景情况:
- 慢性淋巴细胞白血病 (CLL) 患者免疫力受损,增加感染风险.
- 接种疫苗对CLL患者至关重要,但他们的免疫反应,特别是活跃治疗期间,需要进一步了解.
- 在CLL中评估SARS-CoV-2疫苗免疫性对于管理传染病风险至关重要.
研究的目的:
- 在不同的治疗策略下,对不同治疗策略下的CLL患者的SARS-CoV-2疫苗接种的幽默和细胞免疫反应的特征.
- 将CLL患者的疫苗反应与健康个体进行比较.
- 评估活性癌症治疗对疫苗免疫性和免疫细胞动态的影响.
主要方法:
- 对幽默性 (抗体标位,中和活性) 和细胞性 (B细胞子集,细胞毒性细胞) 免疫反应的比较分析.
- 该研究包括接受标准护理治疗的CLL患者,观察和等待 (W&W) 患者和健康对照.
- 进行了三剂SARS-CoV-2疫苗接种方案,并在接种疫苗后六个月进行了分析.
主要成果:
- 与W&W患者 (71.4%-81.8%) 和健康对照患者相比,接受治疗的CLL患者 (22.2%-28.6%) 的血清转化率明显较低.
- 抗体标位和中和活性反映了血清转化率,表明在积极治疗时疫苗有效性降低.
- 虽然接受治疗的CLL患者具有更多的细胞毒性细胞,但它们的激活能力和直接细胞毒性功能没有得到增强;W&W患者表现出更好的PBMC细胞毒性能力.
结论:
- 在CLL中的活性癌症疗法显著损害了SARS-CoV-2疫苗的免疫性,影响了抗体的产生和中和能力.
- 与积极治疗相比,观察和等待策略更好地保留了B细胞种群和整体疫苗反应能力.
- 目前的SARS-CoV-2疫苗接种策略支持CLL患者,但由于可变的免疫反应,特别是治疗个体,密切监测是必不可少的.
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