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成人血液和实体恶性肿瘤患者接种 SARS-CoV-2 第三剂加强疫苗后的抗体反应:系统评价。

Antibody response to a third booster dose of SARS-CoV-2 vaccination in adults with haematological and solid cancer: a systematic review.

机构信息

School of Medicine, University of Birmingham, Birmingham, B15 2TT, UK.

School of Medicine and Biomedical Sciences, University of Oxford, Oxford, OX3 9DU, UK.

出版信息

Br J Cancer. 2022 Nov;127(10):1827-1836. doi: 10.1038/s41416-022-01951-y. Epub 2022 Oct 12.

Abstract

BACKGROUND

Patients living with cancer are at a significantly increased risk of morbidity and mortality after infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This systematic review aims to investigate the current available evidence about the immunogenicity of SARS-CoV-2 booster vaccines in patients living with cancer.

METHODS

A systematic search was undertaken for studies published until March 1, 2022. A systematic narrative review was undertaken to include all studies that evaluated the efficacy of booster vaccines against SARS-CoV-2 in patients with cancer.

RESULTS

Fifteen studies encompassing 1205 patients with cancer were included. We found that a booster vaccine dose induced a higher response in patients with solid cancer as compared to haematological malignancies. Recent systemic anticancer therapy does not appear to affect seroconversion in solid organ malignancies, however, there is an association between B-cell depleting therapies and poor seroconversion in haematological patients.

CONCLUSIONS

Third booster vaccination induces an improved antibody response to SARS-CoV-2 in adults with haematological and solid cancer, relative to patients who only receive two doses. Access to vaccination boosters should be made available to patients at risk of poor immunological responses, and the provision of fourth doses may be of benefit to this vulnerable population.

REGISTRATION

PROSPERO number CRD42021270420.

摘要

背景

感染严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)后,癌症患者的发病率和死亡率显著增加。本系统评价旨在调查目前关于癌症患者 SARS-CoV-2 加强疫苗免疫原性的现有证据。

方法

系统检索截至 2022 年 3 月 1 日发表的研究。进行系统叙述性综述,纳入所有评估癌症患者 SARS-CoV-2 加强疫苗疗效的研究。

结果

纳入了 15 项共 1205 例癌症患者的研究。我们发现,与血液系统恶性肿瘤相比,加强疫苗剂量在实体瘤患者中引起更高的反应。最近的全身抗癌治疗似乎不会影响实体恶性肿瘤中的血清转化率,但在血液系统患者中,B 细胞耗竭疗法与不良血清转化率之间存在关联。

结论

与仅接受两剂疫苗的患者相比,第三次加强接种可诱导血液系统和实体恶性肿瘤成人对 SARS-CoV-2 的抗体反应得到改善。应向免疫反应不良风险患者提供疫苗加强针接种,并为这一脆弱人群提供第四剂疫苗可能会受益。

登记号

PROSPERO 编号 CRD42021270420。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/9643423/b725237d9818/41416_2022_1951_Fig1_HTML.jpg

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