血液系统恶性肿瘤患者对 COVID-19 疫苗的免疫反应减弱。关于这些患者对疫苗剂量的反应的数据有限。为了量化第 4 剂及后续剂量 SARS-CoV-2 疫苗接种产生的体液免疫反应，根据干血，通过抗 Spike（抗 S）抗体水平进行测量血液系统恶性肿瘤患者进行斑点（DBS）检测。 Anti-S 与 SARS-CoV-2 病毒的刺突蛋白结合，表明疫苗具有免疫原性。我们于 2021 年 8 月至 2023 年 1 月期间在加拿大 12 个地点进行了一项血液恶性肿瘤前瞻性研究。对参与者进行纵向跟踪，并按与疫苗接种相关的设定时间间隔提交手指刺破 DBS 卡。通过高通量 ELISA 检测处理样品，以检测抗核衣壳 (N) 和刺突 (S) 蛋白的血清抗体。我们获得了 790 名独特患者的 3071 个样品。其中，372 名独特的参与者拥有 1840 个样本，在接种第 4 剂、第 5 剂或第 6 剂 COVID-19 疫苗后获得了抗 S 结果，并被纳入分析。 372 名参与者中的 333 名患者在第 4 次给药后提交了 DBS 样本。其中，257 名患者（77.2%）的抗 S 抗体呈阳性。总共 198 名患者在服药 4 前后进行了配对样本，其中 59 名患者（29.7%）在服药 4 前抗 S 抗体呈阴性。其中 20 名患者（33.4%）在服药后抗 S 抗体呈阳性。 -剂量4。149名患者在剂量5后提交了DBS样本。其中，135名患者(90.6%)具有阳性抗S抗体。总共 52 名受试者在第 5 次给药前和后具有配对样本。6 名（8.7%）在第 5 次给药前抗 S 抗体呈阴性，其中 2 名（33.3%）在第 5 次给药后抗 S 抗体呈阳性。在这 372 名患者中，123 名患者 (34%) 报告了 COVID-19 感染，4 名患者 (1%) 曾因 COVID-19 住院治疗。目前尚无 COVID-19 死亡报告。这项前瞻性队列研究表明，后续剂量的 COVID-19 疫苗可改善体液免疫反应。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Immune response to COVID-19 vaccine is diminished in patients with hematologic malignancy. There is limited data regarding response to vaccine doses in these patients.To quantify the humoral immune response engendered by 4th and subsequent doses of SARS-CoV-2 vaccination as measured by anti-Spike (anti-S) antibody levels, based on dried blood spot (DBS) testing, in patients with hematologic malignancies. Anti-S binds to the spike protein of the SARS-CoV-2 virus and is indicative of vaccine immunogenicity.We conducted a prospective study of hematologic malignancies between August 2021 and January 2023 at 12 sites across Canada. Participants were followed longitudinally and submitted finger-prick DBS cards at set intervals associated with vaccination. Samples were processed via high throughput ELISA assay to detect serum antibodies against nucleocapsid (N) and spike (S) proteins.We obtained 3071 samples on 790 unique patients. Of these, 372 unique participants with 1840 samples had anti-S results available post-4th, 5th or 6th COVID-19 vaccine dose and were included for analysis. Three hundred thirty-three patients of the 372 participants submitted a DBS sample post 4th dose. Of these, 257 patients (77.2%) had a positive anti-S antibody. A total of 198 patients had paired samples pre- and post-dose 4, of which 59 (29.7%) had a negative anti-S antibody pre-dose 4. Of these, 20 (33.4%) developed positive anti-S antibody post-dose 4. One hundred forty-nine patients submitted a DBS sample post-dose 5. Of these, 135 patients (90.6%) had positive anti-S antibody. A total of 52 had paired samples pre- and post-dose 5. Six (8.7%) had a negative anti-S antibody pre-dose 5, of which two (33.3%) developed positive anti-S antibody post-dose 5. Of these 372 patients, 123 (34%) reported COVID-19 infection and 4 (1%) had a COVID-19 related hospitalization. There were no reported deaths from COVID-19.This prospective cohort study showed that humoral immune response improved with subsequent doses of COVID-19 vaccines.Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.