Abstract：
Vaccination against SARS-COV-2 is considered the most promising approach to curbing the pandemic. Patients with an immunocompromised state, such as those with hematological malignancies and organ transplantation recipients, are considered more susceptible to infection, but these at-risk patients were underrepresented in early clinical trials for vaccination. Although a growing body of studies suggests that the humoral response to COVID-19 vaccination in each of these at-risk groups of patients may be suboptimal in comparison to healthy controls, a clinical and strategic information for the further comparative analysis among these groups is not fully described. The humoral responses after two doses of BNT162b2 vaccination were evaluated in a total of 187 patients either with allogeneic hematopoietic transplantation, with renal transplantation, with anti-CD20 antibody therapy, or with anti-CD38 antibody therapy, and in 66 healthy controls. The early response at one to three months after vaccination was significantly inferior among patients with renal transplantation, patients with anti-CD20 antibody therapy, and patients with anti-CD38 antibody therapy in comparison to healthy control. But the patients with allogeneic hematopoietic transplantation showed early humoral response comparable to healthy control. The late response at 6 months after vaccination was still suboptimal among patients with renal transplantation and patients with anti-CD20 therapy. Among our patient group, renal transplant recipients had the lowest antibody titers after vaccination regardless of timing of vaccination. Patients who had received allogeneic hematopoietic transplantation attained a comparable serological response to the control group especially if they are vaccinated >300 days after transplantation, but the response was suboptimal if the vaccination was within 300 days after transplantation. Our results may provide policy makers with critical information for the further stratification of at-risk groups, helping contribute to a better allocation of resources, including additional booster vaccination.
摘要：
针对SARS-COV-2的疫苗接种被认为是遏制大流行的最有希望的方法。免疫受损状态的患者，例如血液系统恶性肿瘤和器官移植受者，被认为更容易受到感染，但这些高危患者在疫苗接种的早期临床试验中代表性不足.尽管越来越多的研究表明，与健康对照组相比，这些高危患者中每一组对COVID-19疫苗接种的体液反应可能并不理想，这些组之间进一步比较分析的临床和战略信息尚未完全描述.在总共187名接受异基因造血移植的患者中评估了两剂BNT162b2疫苗接种后的体液反应。肾移植，抗CD20抗体治疗，或抗CD38抗体治疗，在66个健康对照中。肾移植患者在疫苗接种后1至3个月的早期反应明显较差，抗CD20抗体治疗的患者，与健康对照相比，接受抗CD38抗体治疗的患者。但是异基因造血移植的患者表现出与健康对照相当的早期体液反应。在肾移植患者和抗CD20治疗患者中，疫苗接种后6个月的晚期反应仍然欠佳。在我们的病人群体中，无论接种时间如何,肾移植受者在接种疫苗后的抗体滴度最低.接受异基因造血移植的患者获得了与对照组相当的血清学反应，特别是如果他们在移植后>300天接种疫苗，但如果在移植后300天内接种疫苗，则反应欠佳。我们的结果可能会为政策制定者提供进一步分层的关键信息，有助于更好地分配资源，包括额外的加强疫苗接种。
