Understanding antibody-based SARS-CoV-2 immunity in hematologic malignancy (HM) patients following infection is crucial to inform vaccination strategies for this highly vulnerable population. This cross-sectional study documents the anti-SARS-CoV-2 humoral response and serum neutralizing activity in 189 HM patients recovering from a PCR-confirmed infection. The overall seroconversion rate was 85.7%, with the lowest values in patients with lymphoid malignancies or undergoing chemotherapy. Therapy-naive patients in the “watch and wait” status were more likely to seroconvert and display increased anti-s IgG titers. Enhanced serum neutralizing activity was observed in the following SARS-CoV-2-infected HM patient groups: (i) males; (ii) severe COVID-19; and (iii) “watch and wait” or “complete/partial response”. The geometric mean (GeoMean) ID50 neutralization titers in patients analyzed before or after 6 months post-infection were 299.1 and 306.3, respectively, indicating that >50% of the patients in either group had a neutralization titer sufficient to provide 50% protection from symptomatic COVID-19. Altogether, our findings suggest that therapy-naive HM patients mount a far more robust immune response to SARS-CoV-2 infection vs. patients receiving anti-cancer treatment, raising the important question as to whether HM patients should be vaccinated before therapy and/or receive vaccine formats capable of better recapitulating the natural infection.
理解血液系统恶性肿瘤（HM）患者感染后基于抗体的SARS-CoV-2免疫力，对于指导这一高度脆弱人群的疫苗接种策略至关重要。这项横断面研究记录了189名经PCR确认感染后恢复的HM患者的抗SARS-CoV-2体液免疫应答及血清中和活性。总体血清转化率为85.7%，其中淋巴系统恶性肿瘤或正在接受化疗的患者血清转化率最低。处于“观察等待”状态且未经治疗的患者更易发生血清转化，并表现出更高的抗刺突蛋白IgG抗体滴度。在以下感染SARS-CoV-2的HM患者组中观察到增强的血清中和活性：（1）男性；（2）重症COVID-19患者；（3）处于“观察等待”或“完全/部分缓解”状态的患者。感染后6个月内或6个月后分析的患者中，几何平均ID50中和滴度分别为299.1和306.3，这表明两组中均有超过50%的患者具有足够的中和滴度，可提供50%的有症状COVID-19保护。总之，我们的研究结果表明，与接受抗癌治疗的患者相比，未经治疗的HM患者对SARS-CoV-2感染产生了更强的免疫应答，这引发了一个重要问题：HM患者是否应在治疗前接种疫苗，和/或接种能够更好模拟自然感染的疫苗类型。
肿瘤(癌症)患者之家