文章：

多发性骨髓瘤患者接种COVID-19疫苗后的中和抗体反应高度依赖于抗骨髓瘤治疗的类型

The neutralizing antibody response post COVID-19 vaccination in patients with myeloma is highly dependent on the type of anti-myeloma treatment

原文发布日期：2021-08-02

DOI: 10.1038/s41408-021-00530-3

类型: Article

开放获取: 是

英文摘要：

Recent data suggest a suboptimal antibody response to COVID-19 vaccination in patients with hematological malignancies. Neutralizing antibodies (NAbs) against SARS-CoV-2 were evaluated in 276 patients with plasma cell neoplasms after vaccination with either the BNT162b2 or the AZD1222 vaccine, on days 1 (before the first vaccine shot), 22, and 50. Patients with MM (n = 213), SMM (n = 38), and MGUS (n = 25) and 226 healthy controls were enrolled in the study (NCT04743388). Vaccination with either two doses of the BNT162b2 or one dose of the AZD1222 vaccine leads to lower production of NAbs in patients with MM compared with controls both on day 22 and on day 50 (p < 0.001 for all comparisons). Furthermore, MM patients showed an inferior NAb response compared with MGUS on day 22 (p = 0.009) and on day 50 (p = 0.003). Importantly, active treatment with either anti-CD38 monoclonal antibodies (Mabs) or belantamab mafodotin and lymphopenia at the time of vaccination were independent prognostic factors for suboptimal antibody response following vaccination. In conclusion, MM patients have low humoral response following SARS-CoV-2 vaccination, especially under treatment with anti-CD38 or belamaf. This underlines the need for timely vaccination, possibly during a treatment-free period, and for continuous vigilance on infection control measures in non-responders.
 

摘要翻译： 

近期数据显示，血液系统恶性肿瘤患者对新冠疫苗接种的抗体反应欠佳。一项研究（NCT04743388）对276名浆细胞肿瘤患者接种BNT162b2或AZD1222疫苗后第1天（首剂前）、第22天和第50天的SARS-CoV-2中和抗体水平进行了评估，入组者包括多发性骨髓瘤患者213例、冒烟型骨髓瘤患者38例、意义未明的单克隆丙种球蛋白血症患者25例以及226名健康对照者。无论是接种两剂BNT162b2疫苗还是单剂AZD1222疫苗，多发性骨髓瘤患者在第22天和第50天的中和抗体生成量均低于对照组（所有比较p<0.001）。此外，与意义未明的单克隆丙种球蛋白血症患者相比，多发性骨髓瘤患者在第22天（p=0.009）和第50天（p=0.003）的中和抗体反应更弱。值得注意的是，接种时正在接受抗CD38单克隆抗体或贝兰他单抗马福多汀治疗，以及伴有淋巴细胞减少，均是疫苗接种后抗体反应欠佳的独立预后因素。综上所述，多发性骨髓瘤患者接种SARS-CoV-2疫苗后体液免疫反应较低，尤其在接受抗CD38药物或贝兰他单抗马福多汀治疗期间。这强调了对该类患者需要在无治疗期及时接种疫苗，并对无应答者持续严格实施感染控制措施。

原文链接：

The neutralizing antibody response post COVID-19 vaccination in patients with myeloma is highly dependent on the type of anti-myeloma treatment