抗SARS-COV2-促进疫苗接种后血液学和肿瘤患者的抗SARS-COV2-促进疫苗后，体液免疫反应作为防止COVID-19的指标
Humoral immune response as an indicator for protection against Covid-19 after anti-SARS-COV2-booster vaccination in hematological and oncological patients
影响因子:4.70000
分区:医学2区 / 肿瘤学2区
发表日期:2024 Dec 15
作者:
Dieter Mainka, Nathalie Bauer, Lutz Dietze, Sonja Lehnert, Johanna Krandick, Daniel Himmelreich, Hassan Jomaa, Maximilian Zimmermann, Peter Borchmann, Swetlana Herbrandt, Achim Rothe
摘要
与普通人群相比，SARS-COV-2感染后发生严重的CoVID-19症状的风险更高，并且经常显示对SARS-COV-2疫苗接种的免疫反应受损。在我们的肿瘤学中心，从2021年10月开始，监测了357例血液学和肿瘤疾病患者的中和抗体。所有患者均接受了三种抗SARS-COV-2疫苗接种疫苗，并带有mRNA-（Comirnaty/Biontech或Spikevax/Moderna）或载体疫苗（Vakzevria/Astrazeneca或Jcovden/Jcovden/Johnson＆Johnson）。在3个月前，3-10周和升高疫苗接种后的3-10周和5-7个月内，检测到患者血清中中和抗SARS-COV-2 IgG抗体（第三次疫苗接种）。在观察期间，112例患者发展出突破性的SARS-COV-2感染。感染前高的抗SARS-COV-2抗体水平受到症状性共证疾病的明显保护（p = .003）。无症状COVID-19疾病患者的中值抗体滴度为2080 BAU/ML（每毫升结合抗体单元）和有症状患者的765 BAU/mL。与79％的血液学患者相比，增强疫苗接种后，有98％的实体瘤患者达到了血清转化。在61％的肿瘤学和34.8％的血液学患者中检测到升高疫苗接种后的高抗体滴度> 2080 BAU/mL。加强疫苗接种后7-10个月，抗SARS-COV-2抗体滴度平均下降到849 BAU/mL。考虑到这项研究中观察到的癌症患者的异质体液免疫反应，与固定的疫苗接种间隔相比，应考虑基于定期测量抗SARS-COV-2抗体水平的个人疫苗接种策略。
Abstract
Cancer patients are at a higher risk to develop severe COVID-19 symptoms after SARS-CoV-2 infection compared to the general population and regularly show an impaired immune response to SARS-CoV-2 vaccination. In our oncological center, 357 patients with hematological and oncological diseases were monitored for neutralizing antibodies from October 2021 over 12 months. All patients had received three anti-SARS-CoV-2 vaccinations with an mRNA-(Comirnaty/BionTech or Spikevax/Moderna) or a vector vaccine (Vakzevria/AstraZeneca or JCOVDEN/Johnson&Johnson). Neutralizing anti-SARS-CoV-2 IgG antibodies in the patients' sera were detected within 3 months before, 3-10 weeks and 5-7 months after the booster vaccination (third vaccination). 112 patients developed a breakthrough SARS-CoV-2 infection during the observation period. High anti-SARS-Cov-2 antibody levels before infection significantly protected against symptomatic Covid-19 disease (p = .003). The median antibody titer in patients with asymptomatic Covid-19 disease was 2080 BAU/ml (binding antibody units per Milliliter) and 765 BAU/ml in symptomatic patients. 98% of the solid tumor patients reached seroconversion after the booster vaccination in comparison to 79% of the hematological patients. High antibody titers of >2080 BAU/ml after the booster vaccination were detected in 61% of the oncological and 34.8% of the hematological patients. 7-10 months after the booster vaccination, the anti-SARS-CoV-2 antibody titer declined to an average of 849 BAU/ml. Considering the heterogenous humoral immune response of cancer patients observed in this study, an individual vaccination strategy based on regular measurement of anti-SARS-CoV-2 antibody levels should be considered in contrast to fixed vaccination intervals.