人们对 COVID-19 疫苗在急性淋巴细胞白血病 (ALL) 治疗期间的功效知之甚少；儿童白血病的 COVID-19 疫苗免疫反应数据仍然很少。我们对接受 ALL 化疗且接受了 COVID-19 疫苗接种的 5-25 岁患者进行了一项单中心研究。 21 名患者入组；疗效在 20 人中进行评估。其中 20 人在接受化疗的同时接种了疫苗。 20 人接种了 BNT162b2 mRNA 疫苗。在 20 名接种疫苗的患者中，有 16 名 (80%) 检测到了尖峰反应性抗体 (S-IgG) 和/或 T 细胞 (SRT)；分别有 13 名 (65%) 和 9 名 (45%) 呈 S-IgG 和 SRT 阳性。六人 (30%) 同时表现出尖峰反应性 B 细胞和 T 细胞反应。 13 名 S-IgG 呈阳性的人中有 11 名抗核衣壳 IgG 呈阴性，这种抗体谱与疫苗诱导的免疫反应一致。所有 13S-IgG 患者均显示中和抗体。 SRT 包括 CD4 (7) 和 CD8 (6) T 细胞； CD4 和 CD8 SRT 均见于 4 例。大多数患者（9 例中有 8 例）SRT 具有多功能性（产生多种细胞因子）；图4显示具有三重细胞因子和B细胞共刺激反应的SRT，表明多模式适应性免疫反应。在淋巴细胞减少（12 名中的 6 名）、强化化疗（4 名中的 3 名）和 Peg 过敏（8 名中的 6 名）的情况下接种疫苗的患者出现了免疫反应。测序揭示了公共 CD4 和 CD8 TCR 序列对刺突蛋白上的表位有反应。总之，COVID-19 疫苗接种在大多数接受 ALL 化疗的儿童和年轻人中诱导了 B 和/或 T 细胞反应。© 2024 UICC。

Little is known about the efficacy of COVID-19 vaccines during acute lymphoblastic leukemia therapy (ALL); data for COVID-19 vaccine immune responses in pediatric leukemia remain sparse. We conducted a single center study of patients aged 5-25 years undergoing ALL chemotherapy who received COVID-19 vaccination. Twenty-one patients were enrolled; efficacy was evaluable in 20. Twenty were vaccinated while receiving chemotherapy. Twenty received the BNT162b2 mRNA vaccine. Spike reactive antibodies (S-IgG) and/or T-cells (SRT) were detected in 16 of 20 (80%) vaccinated patients; 13 (65%) and 9 (45%) were positive for S-IgG and SRT, respectively. Six (30%) showed both spike reactive B and T-cell responses. Eleven of the 13 with S-IgG positivity were negative for anti-Nucleocapsid IgG, an antibody profile consistent with a vaccine induced immune response. All 13S-IgG+ patients showed neutralizing antibodies. SRT included CD4+ (7) and CD8+ (6) T-cells; both CD4+ and CD8+ SRT were seen in 4. SRT were multifunctional (producing multiple cytokines) in most patients (8 of 9); 4 showed SRT with triple cytokine and B-cell co-stimulatory responses, indicating a multimodal adaptive immune response. Immune responses were seen among patients vaccinated in the settings of lymphopenia (6 of 12) intensive chemotherapy (3 of 4), and Peg allergy (6 of 8). Sequencing revealed public CD4+ and CD8+ TCR sequences reactive to epitopes across the spike protein. In conclusion, COVID-19 vaccination induced B and/or T-cell responses in a majority of children and young adults undergoing ALL chemotherapy.© 2024 UICC.