J Hematol Oncol:多发性骨髓瘤患者对COVID-19 mRNA接种的反应是保守但受损的

2021-10-18 MedSci原创 MedSci原创

多发性骨髓瘤患者对COVID-19 mRNA接种的反应是保守但受损的

多发性骨髓瘤患者是COVID-19重症的高危患者,尽管数据显示其对疫苗的反应减弱,但高效mRNA疫苗的时代可能是一个游戏改变者。国外一专家团队试图检测健康对照组(n=28)和多发性骨髓瘤(MM)患者(n=27)对mRNA疫苗的反应,进行了一项病例对照研究,比较了健康对照组在第二剂BNT162b2疫苗接种1个月后(HC)和多发性骨髓瘤(MM)患者中抗SARS-CoV-2抗体的抗峰值IgG反应和中和活性。分析了与MM患者无反应相关的因素。

 

 

与对照组相比,多发性骨髓瘤患者的抗棘突IgG水平下降,但达到体液反应的患者比例很高(89% vs 97%,对照组)。中和抗体在74%的患者和96%的对照组中存在。目前接受单抗治疗的患者具有抗sars - cov -2抗体的中和活性。多发性骨髓瘤患者对SARS-COV-2疫苗应答减弱,但应答率仍较高。

总的来说,这些结果支持MM患者对2剂抗SARS CoV 2 BNT162b2疫苗的应答低于HC。很大比例的MM患者仍可有体液反应,MM为75%,HC为96%。在慢性淋巴细胞白血病中,使用以抗cd20为基础的治疗方案的患者在前一年接受了该药物,并将其与完全无反应的患者进行比较。即使大多数MM患者获得体液免疫,抗尖突和中和抗体的滴度的降低也是一个值得关注的问题。他们发现治疗上的无控制MM是对COVID-19疫苗无反应的主要潜在危险因素。这需要在更大的研究中得到证实。对于这些无反应的患者,至关重要的是对其家庭成员和主要照顾者进行疫苗接种。在MM患者中应评估第三剂量的使用。

 

原始出处:

Bitoun, S., Henry, J., Vauloup-Fellous, C. et al. Response to COVID-19 mRNA vaccination in multiple myeloma is conserved but impaired compared to controls. J Hematol Oncol 14, 166 (2021). https://doi.org/10.1186/s13045-021-01183-2

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    2021-12-08 minlingfeng
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    2022-06-23 jml2009
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    2021-10-20 fengyi812
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    2021-10-18 医鸣惊人

    认真学习了。

    0

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