多发性骨髓瘤疫苗接种:挑战和策略
Enrica Antonia Martino1, Ernesto Vigna1, Antonella Bruzzese1
1Hematology Unit, Department of Onco-Hematology, Cosenza, Italy.
European journal of haematology
|July 27, 2025
概括
疫苗接种对于预防多发性骨髓瘤 (MM) 患者感染至关重要,尽管存在免疫挑战. 个性化疫苗接种策略对于改善临床效益和降低这一弱势群体感染风险至关重要.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 多发性骨髓瘤 (MM) 患者由于疾病和治疗而经历严重的免疫抑制.
- 这种免疫功能障碍增加了对感染的易感性,这是死亡的主要原因.
- 标准疫苗在多发性骨髓瘤患者中通常表现出有限的有效性.
研究的目的:
- 审查目前关于MM疫苗接种的证据,重点关注免疫障碍和临床有效性.
- 评估流感疫苗,肺炎球菌,SARS-CoV-2和其他病原体在MM.
- 探索影响疫苗疗效的因素,如时间,配方和患者免疫状况.
主要方法:
- 进行了全面的文献审查.
- 包括的研究:临床试验,队列研究,指导方针和人口数据.
- 评估结果:血清学反应,感染率和疫苗安全性.
主要成果:
- 许多MM患者的疫苗反应受损,原因是低血和免疫细胞功能障碍.
- 流感和肺炎球菌疫苗减少了感染和住院,具体方案显示了移植后的好处.
- 接种COVID-19疫苗的反应有所不同,特别是在某些疗法中,需要增强剂和潜在的预防性抗体.
结论:
- 疫苗接种对于预防MM的感染至关重要,尽管免疫原性减弱,但具有临床益处.
- 考虑治疗,疾病控制和免疫状况的个性化方法是最佳疫苗有效性的关键.
- 需要对先进的疫苗配方进行进一步的研究,以加强对这一群体的保护.
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