决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Third dose of SARS-CoV-2 vaccination in hemato-oncological patients and health care workers: immune responses and adverse events - a retrospective cohort study.
这项在癌症患者中进行的研究显示,接种第三剂疫苗后抗体水平提高,且副作用可接受。抗体水平低于对照组,这凸显了进一步随访研究和专门试验的必要性。
由于可能存在免疫逃逸的病毒变异株和免疫力减弱,越来越多地推荐接种第三剂SARS-CoV-2疫苗。然而,癌症患者中的数据有限。
我们在奥地利一家学术中心和意大利一家农村社区医院测量了439例癌症患者和41名医护人员(HCW)在接种第三剂疫苗后的抗SARS-CoV-2刺突蛋白抗体水平。不良事件从问卷中获取。
总体而言,共纳入439例患者和41名HCW。在接种疫苗前观察到62/439(14.1%)例患者发生SARS-CoV-2感染,在接种≥1剂后观察到5/439(1.1%)例患者发生感染。纵向分析显示,在实体瘤患者(p < 0.001)和未接受抗B细胞治疗的血液恶性肿瘤患者(p < 0.001)中,第二剂疫苗接种后3至6个月之间抗体水平下降。第三剂接种后,anti-S水平较第一剂/第二剂升高。接受B细胞靶向药物治疗的患者抗体水平低于接受其他治疗的血液恶性肿瘤患者(p < 0.001)或实体瘤患者(p < 0.001)。此外,anti-S水平与外周血中CD19+(B细胞)和CD56+(NK细胞)计数相关。第三剂接种后最常见的不良事件为局部疼痛(75/160,46.9%)、乏力(25/160,15.6%)和发热/寒战(16/160,10.0%)。癌症患者的anti-S水平低于HCW(p = 0.015)。
BACKGROUND: Due to potentially immune-escaping virus variants and waning immunity, a third SARS-CoV-2 vaccination dose is increasingly recommended. However, data in patients with cancer are limited. PATIENTS AND METHODS: We measured anti-SARS-CoV-2 spike protein antibody levels after the third vaccination dose in 439 patients with cancer and 41 health care workers (HCW) at an academic centre in Austria and a rural community hospital in Italy. Adverse events were retrieved from questionnaires. RESULTS: Overall, 439 patients and 41 HCW were included. SARS-CoV-2 infections were observed in 62/439 (14.1%) patients before vaccination and in 5/439 (1.1%) patients after ≥1 dose. Longitudinal analysis revealed a decrease of antibody levels between 3 and 6 months after second vaccination in patients with solid tumours (p < 0.001) and haematological malignancies without anti-B cell therapies (p < 0.001). After the third dose, anti-S levels increased compared to the first/second dose. Patients receiving B cell-targeted agents had lower antibody levels than patients with haematological malignancies undergoing other treatments (p < 0.001) or patients with solid tumours (p < 0.001). Moreover, anti-S levels correlated with CD19+ (B cell) and CD56+ (NK cell) counts in peripheral blood. The most frequent adverse events after the third dose were local pain (75/160, 46.9%), fatigue (25/160, 15.6%) and fever/chills (16/160, 10.0%). Patients with cancer had lower anti-S levels than HCW (p = 0.015). CONCLUSIONS: This study in patients with cancer shows improved antibody levels after the third vaccination dose at an acceptable side-effect profile. Lower antibody levels than in controls underline the need for further follow-up studies and dedicated trials.
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