PDF(Pubmed)
Abstract：
The humoral response to vaccination in individuals with lymphoid malignancies or those undergoing anti-CD20 antibody therapy is impaired, but details of the response to mRNA vaccines to protect against COVID-19 remain unclear. This systematic review and meta-analysis aimed to characterize the response to COVID-19 mRNA vaccines in patients with lymphoid malignancies or those undergoing anti-CD20 antibody therapy.
A literature search retrieved 52 relevant articles, and random-effect models were used to analyze humoral and cellular responses.
Lymphoid malignancies and anti-CD20 antibody therapy for non-malignancies were significantly associated with lower seropositivity rates (risk ratio 0.60 [95% CI 0.53-0.69]; risk ratio 0.45 [95% CI 0.39-0.52], respectively). Some subtypes (chronic lymphocytic leukemia, treatment-naïve chronic lymphocytic leukemia, myeloma, and non-Hodgkin\'s lymphoma) exhibited impaired humoral response. Anti-CD20 antibody therapy within 6 months of vaccination decreased humoral response; moreover, therapy > 12 months before vaccination still impaired the humoral response. However, anti-CD20 antibody therapy in non-malignant patients did not attenuate T cell responses.
These data suggest that patients with lymphoid malignancies or those undergoing anti-CD20 antibody therapy experience an impaired humoral response, but cellular response can be detected independent of anti-CD20 antibody therapy. Studies with long-term follow-up of vaccine effectiveness are warranted (PROSPERO registration number: CRD42021265780).
A literature search retrieved 52 relevant articles, and random-effect models were used to analyze humoral and cellular responses.
Lymphoid malignancies and anti-CD20 antibody therapy for non-malignancies were significantly associated with lower seropositivity rates (risk ratio 0.60 [95% CI 0.53-0.69]; risk ratio 0.45 [95% CI 0.39-0.52], respectively). Some subtypes (chronic lymphocytic leukemia, treatment-naïve chronic lymphocytic leukemia, myeloma, and non-Hodgkin\'s lymphoma) exhibited impaired humoral response. Anti-CD20 antibody therapy within 6 months of vaccination decreased humoral response; moreover, therapy > 12 months before vaccination still impaired the humoral response. However, anti-CD20 antibody therapy in non-malignant patients did not attenuate T cell responses.
These data suggest that patients with lymphoid malignancies or those undergoing anti-CD20 antibody therapy experience an impaired humoral response, but cellular response can be detected independent of anti-CD20 antibody therapy. Studies with long-term follow-up of vaccine effectiveness are warranted (PROSPERO registration number: CRD42021265780).
摘要：
淋巴恶性肿瘤患者或接受抗CD20抗体治疗的患者对疫苗接种的体液反应受损，但mRNA疫苗对抗COVID-19的反应细节尚不清楚.这项系统评价和荟萃分析旨在描述淋巴恶性肿瘤患者或接受抗CD20抗体治疗的患者对COVID-19mRNA疫苗的反应。
文献检索检索到52篇相关文章,随机效应模型用于分析体液和细胞反应。
淋巴恶性肿瘤和非恶性肿瘤的抗CD20抗体治疗与较低的血清阳性率显着相关（风险比0.60[95％CI0.53-0.69]；风险比0.45[95％CI0.39-0.52]，分别)。一些亚型（慢性淋巴细胞白血病，治疗-初治慢性淋巴细胞白血病，骨髓瘤,和非霍奇金淋巴瘤）表现出体液反应受损。疫苗接种后6个月内的抗CD20抗体治疗降低了体液反应；此外，疫苗接种前>12个月的治疗仍损害体液应答.然而,非恶性患者的抗CD20抗体治疗未减弱T细胞应答.
这些数据表明，患有淋巴恶性肿瘤或接受抗CD20抗体治疗的患者的体液反应受损，但细胞反应可以检测到独立于抗CD20抗体治疗。疫苗有效性的长期随访研究是必要的（PROSPERO注册号：CRD42021265780）。
文献检索检索到52篇相关文章,随机效应模型用于分析体液和细胞反应。
淋巴恶性肿瘤和非恶性肿瘤的抗CD20抗体治疗与较低的血清阳性率显着相关（风险比0.60[95％CI0.53-0.69]；风险比0.45[95％CI0.39-0.52]，分别)。一些亚型（慢性淋巴细胞白血病，治疗-初治慢性淋巴细胞白血病，骨髓瘤,和非霍奇金淋巴瘤）表现出体液反应受损。疫苗接种后6个月内的抗CD20抗体治疗降低了体液反应；此外，疫苗接种前>12个月的治疗仍损害体液应答.然而,非恶性患者的抗CD20抗体治疗未减弱T细胞应答.
这些数据表明，患有淋巴恶性肿瘤或接受抗CD20抗体治疗的患者的体液反应受损，但细胞反应可以检测到独立于抗CD20抗体治疗。疫苗有效性的长期随访研究是必要的（PROSPERO注册号：CRD42021265780）。
