文章：

慢性淋巴细胞白血病患者在首次和第二次新冠疫苗接种后的抗体反应

Antibody responses after first and second Covid-19 vaccination in patients with chronic lymphocytic leukaemia

原文发布日期：2021-07-30

DOI: 10.1038/s41408-021-00528-x

类型: Article

开放获取: 是

英文摘要：

B-cell chronic lymphocytic leukaemia (CLL) is associated with immunosuppression and patients are at increased clinical risk following SARS-CoV-2 infection. Covid-19 vaccines offer the potential for protection against severe infection but relatively little is known regarding the profile of the antibody response following first or second vaccination. We studied spike-specific antibody responses following first and/or second Covid-19 vaccination in 299 patients with CLL compared with healthy donors. 286 patients underwent extended interval (10–12 week) vaccination. 154 patients received the BNT162b2 mRNA vaccine and 145 patients received ChAdOx1. Blood samples were taken either by venepuncture or as dried blood spots on filter paper. Spike-specific antibody responses were detectable in 34% of patients with CLL after one vaccine (n = 267) compared to 94% in healthy donors with antibody titres 104-fold lower in the patient group. Antibody responses increased to 75% after second vaccine (n = 55), compared to 100% in healthy donors, although titres remained lower. Multivariate analysis showed that current treatment with BTK inhibitors or IgA deficiency were independently associated with failure to generate an antibody response after the second vaccine. This work supports the need for optimisation of vaccination strategy in patients with CLL including the potential utility of booster vaccines.
 

摘要翻译： 

B细胞慢性淋巴细胞白血病（CLL）常伴随免疫抑制状态，患者感染SARS-CoV-2后临床风险显著升高。新冠疫苗虽能提供针对重症感染的潜在保护，但关于首次或第二次接种后抗体反应特征的研究仍相对有限。本研究比较了299例CLL患者与健康供体在第一剂和/或第二剂新冠疫苗接种后的刺突蛋白特异性抗体反应。其中286例患者采用延长间隔(10-12周)接种方案，154例接受BNT162b2 mRNA疫苗，145例接受ChAdOx1疫苗。通过静脉穿刺或滤纸干血斑方式采集血液样本。

结果显示：首次接种后（n=267），仅34%的CLL患者可检测到刺突蛋白特异性抗体反应，而健康供体组达94%，且患者组抗体滴度低约104倍；第二次接种后（n=55），患者抗体反应率提升至75%（健康供体组为100%），但滴度仍持续偏低。多变量分析表明，当前接受BTK抑制剂治疗或存在IgA缺陷是患者第二次接种后无法产生抗体反应的独立影响因素。本研究证实了优化CLL患者疫苗接种策略的必要性，包括加强疫苗的潜在应用价值。

原文链接：

Antibody responses after first and second Covid-19 vaccination in patients with chronic lymphocytic leukaemia