在患有古典性和变异性毛状细胞白血病的患者中接种COVID-19疫苗
Robert J Kreitman1, Lacey James1, Julie Feurtado2
1Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD.
Blood neoplasia
|June 24, 2025
概括
患有毛细胞白血病 (HCL) 和其变体 (HCLv) 的患者由于疾病和抗CD20疗法的B细胞水平较低,导致COVID-19疫苗的有效性降低,影响抗体产生并可能增加感染风险.
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:
- 毛细胞白血病 (HCL) 和它的变体 (HCLv) 是B细胞恶性瘤.
- 用抗CD20单克隆抗体 (mAbs) 治疗会消耗正常的B细胞,损害幽默免疫力.
- 在这些免疫功能低下的患者中评估COVID-19疫苗反应至关重要.
研究的目的:
- 在HCL和HCLV患者接种疫苗后评估COVID-19抗体水平.
- 确定影响疫苗反应的因素,包括B细胞计数和CD4+T细胞水平.
- 了解抗CD20治疗对长期幽默免疫力的影响.
主要方法:
- 在HCL (n=415) 和HCLv (n=32) 患者的初级和强剂疫苗剂量后,测量了COVID-19抗体水平 (例如,尖端抗体).
- 与正常B细胞计数,CD4+T细胞计数和免疫球蛋白G水平相关的抗体水平.
- 评估了抗CD20治疗后B细胞恢复动态,并分析了COVID-19感染率.
主要成果:
- 疫苗接种后的抗体水平与正常的B细胞水平和CD4+T细胞数量有很强的相关性.
- 在抗CD20治疗后6个月内,87%的患者无法检测到正常的B细胞.
- 在接种第三剂疫苗后,COVID-19感染风险增加,而抗体水平在ibrutinib或抗CD20治疗时下降得更快.
结论:
- 由于疾病或治疗,HCL/HCLv患者的正常B细胞减少与COVID-19疫苗效率降低有关.
- 这些患者可能会对疫苗产生不理想的反应.
- 需要进一步的策略来提高疫苗在B细胞恶性瘤患者的疗效.
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