文章：

COVID-19合并血液系统恶性肿瘤患者特异性抗体的产生与持续：利妥昔单抗的作用

Production and persistence of specific antibodies in COVID-19 patients with hematologic malignancies: role of rituximab

原文发布日期：2021-09-14

DOI: 10.1038/s41408-021-00546-9

类型: Article

开放获取: 是

英文摘要：

The ability of patients with hematologic malignancies (HM) to develop an effective humoral immune response after COVID-19 is unknown. A prospective study was performed to monitor the immune response to SARS-CoV-2 of patients with follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), chronic lymphoproliferative disorders (CLD), multiple myeloma (MM), or myelodysplastic/myeloproliferative syndromes (MDS/MPN). Antibody (Ab) levels to the SARS-CoV-2 nucleocapsid (N) and spike (S) protein were measured at +1, +3, +6 months after nasal swabs became PCR-negative. Forty-five patients (9 FL, 8 DLBCL, 8 CLD, 10 MM, 10 MDS/MPS) and 18 controls were studied. Mean anti-N and anti-S-Ab levels were similar between HM patients and controls, and shared the same behavior, with anti-N Ab levels declining at +6 months and anti-S-Ab remaining stable. Seroconversion rates were lower in HM patients than in controls. In lymphoma patients mean Ab levels and seroconversion rates were lower than in other HM patients, primarily because all nine patients who had received rituximab within 6 months before COVID-19 failed to produce anti-N and anti-S-Ab. Only one patient requiring hematological treatment after COVID-19 lost seropositivity after 6 months. No reinfections were observed. These results may inform vaccination policies and clinical management of HM patients.
 

摘要翻译： 

血液系统恶性肿瘤（HM）患者能否在COVID-19感染后产生有效的体液免疫反应尚不明确。本研究通过一项前瞻性研究，监测了滤泡性淋巴瘤（FL）、弥漫大B细胞淋巴瘤（DLBCL）、慢性淋巴细胞增殖性疾病（CLD）、多发性骨髓瘤（MM）或骨髓增生异常/骨髓增殖性肿瘤（MDS/MPN）患者对SARS-CoV-2的免疫反应。在鼻拭子PCR转阴后的第1、3、6个月，分别检测了患者针对SARS-CoV-2核衣壳（N）蛋白和刺突（S）蛋白的抗体（Ab）水平。研究共纳入45例患者（9例FL、8例DLBCL、8例CLD、10例MM、10例MDS/MPN）和18例对照者。HM患者与对照者的平均抗N抗体和抗S抗体水平相似，且变化趋势一致：抗N抗体水平在第6个月下降，而抗S抗体保持稳定。HM患者的血清转化率低于对照组。淋巴瘤患者的平均抗体水平及血清转化率均低于其他HM患者，主要原因是所有9例在COVID-19感染前6个月内接受过利妥昔单抗治疗的患者均未产生抗N抗体和抗S抗体。仅1例在COVID-19感染后需接受血液学治疗的患者在6个月后转为血清阴性。研究期间未观察到再感染病例。这些结果可为HM患者的疫苗接种策略和临床管理提供参考。

原文链接：

Production and persistence of specific antibodies in COVID-19 patients with hematologic malignancies: role of rituximab