Unfortunately, patients with hematologic malignancies demonstrated poor seroconversion rates following SARS-CoV-2 vaccination compared to healthy people. Vaccines against SARS-CoV-2 have shown effectiveness in the prevention of symptomatic infection and in the reduction of hospitalization and mortality from COVID-19. Furthermore, hematologic malignancy patients suffer higher mortality from coronavirus disease 2019 (COVID-19) than solid cancer patients. Patients with hematologic malignancies, especially acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS), are at high risk of mortality from SARS-CoV-2 infection. Since the first emerging cluster of pneumonia in China in December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected more than 600 million people and caused over 6 million deaths worldwide. Strategies to improve immune response in these severely immunosuppressed patients are needed. A minority of patients attained seroconversion after booster vaccination. In conclusion, HM patients, especially those with lymphoid malignancies and/or receiving CART, B-cell targeted therapies, or JAK inhibitors, showed poor SR after SARS-CoV-2 vaccination. Among non-seroconverted patients after primary vaccination, only 40.5% (95% CI, 33.0–48.4% I 2 = 87%) mounted seroconversion after the booster. Approximately 20.9% (95% CI, 11.4–35.1%, I 2 = 90%) of HM patients failed to elicit humoral and cellular immunity. Patients receiving chimeric antigen receptor T-cells (CART), B-cell targeted therapies or JAK inhibitors were associated with poor seroconversion ( R 2 = 0.39, P < 0.0001). Meta-regression analysis showed that patients with lymphoid malignancies, but not myeloid malignancies, had lower seroconversion rates than those with solid cancers ( R 2 = 0.52, P < 0.0001). A meta-analysis of 150 studies including 20,922 HM patients revealed a pooled SR following SARS-CoV-2 vaccination of 67.7% (95% confidence interval, 64.8–70.4% I 2 = 94%). A total of 170 studies were included for qualitative and quantitative analysis of primary and secondary outcomes. ![]() The secondary aims were to determine the rates of development of neutralizing antibodies (NAb) and CIR following complete vaccination and SR following booster doses. The primary aim was to estimate the seroconversion rate (SR) following complete SARS-CoV-2 vaccination across various subtypes of HM diseases and treatments. A literature search was conducted using PubMed, EMBASE, Cochrane, and medRxiv databases to identify studies that reported humoral or cellular immune responses (CIR) following complete SARS-CoV-2 vaccination. ![]() Factors associated with poor immunogenicity remain largely undetermined. Patients with hematologic malignancies (HM) have demonstrated impaired immune responses following SARS-CoV-2 vaccination.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |