The efficacy of SARS-CoV-2 vaccination in patients with hematological malignancies (HM) appears limited due to disease and treatment-associated immune impairment. We conducted a systematic review of prospective studies published from 10/12/2021 onwards in medical databases to assess clinical efficacy parameters, humoral and cellular immunogenicity and adverse events (AE) following two doses of COVID-19 approved vaccines. In 57 eligible studies reporting 7393 patients, clinical outcomes were rarely reported and rates of SARS-CoV-2 infection (range 0–11.9%), symptomatic disease (0–2.7%), hospital admission (0–2.8%), or death (0–0.5%) were low. Seroconversion rates ranged from 38.1–99.1% across studies with the highest response rate in myeloproliferative diseases and the lowest in patients with chronic lymphocytic leukemia. Patients with B-cell depleting treatment had lower seroconversion rates as compared to other targeted treatments or chemotherapy. The vaccine-induced T-cell response was rarely and heterogeneously reported (26.5–85.9%). Similarly, AEs were rarely reported (0–50.9% ≥1 AE, 0–7.5% ≥1 serious AE). In conclusion, HM patients present impaired humoral and cellular immune response to COVID-19 vaccination with disease and treatment specific response patterns. In light of the ongoing pandemic with the easing of mitigation strategies, new approaches to avert severe infection are urgently needed for this vulnerable patient population that responds poorly to current COVID-19 vaccine regimens.
由于疾病及相关治疗导致的免疫功能损害，血液系统恶性肿瘤（HM）患者接种SARS-CoV-2疫苗的效果似乎有限。我们对2021年10月12日起在医学数据库上发表的前瞻性研究进行了系统综述，以评估接种两剂已获批COVID-19疫苗后的临床疗效参数、体液及细胞免疫原性以及不良事件（AE）。在涵盖7393名患者的57项符合条件的研究中，临床结局的报道较少，且SARS-CoV-2感染率（范围0–11.9%）、有症状疾病发生率（0–2.7%）、住院率（0–2.8%）和死亡率（0–0.5%）均较低。不同研究的血清转换率差异较大（38.1–99.1%），其中骨髓增殖性疾病患者应答率最高，慢性淋巴细胞白血病患者最低。接受B细胞清除治疗的患者，其血清转换率低于其他靶向治疗或化疗患者。疫苗诱导的T细胞应答的报道较少且异质性较高（26.5–85.9%）。同样，不良事件的报道也较为有限（0–50.9%出现≥1项AE，0–7.5%出现≥1项严重AE）。总之，HM患者对COVID-19疫苗接种的体液和细胞免疫应答存在受损，且表现出疾病和治疗特异性的应答模式。鉴于当前大流行持续且防控措施逐步放宽，针对这一对现有COVID-19疫苗方案应答不佳的脆弱患者群体，亟需新的策略来预防重症感染。
肿瘤(癌症)患者之家