肿瘤细胞治疗研究
英文原题：Immune response to vaccination against SARS-CoV-2 in hematopoietic stem cell transplantation and CAR T-cell therapy recipients.
最终共纳入 46 项研究，包括 4757 例 HSCT 受者和 174 例 CAR-T 受者。
造血干细胞移植（HSCT）或CAR-T 细胞治疗受者感染SARS-CoV-2后，发生不良结局的风险增加。COVID-19疫苗在这一脆弱人群中的有效性尚不明确，因此我们开展汇总分析，评估接种后免疫应答。最终纳入46项研究，包括4757例HSCT受者和174例CAR-T受者。结果表明，与健康人相比，HSCT和CAR-T受者对SARS-CoV-2疫苗的免疫应答减弱；移植至接种的时间间隔、免疫抑制治疗（IST）以及接种时淋巴细胞计数，均显著影响HSCT受者的体液免疫应答。此外，BCMA CAR-T患者血清转化率显著高于CD19 CAR-T患者。因此，HSCT和CAR-T受者可能需要调整疫苗接种策略，并有必要进一步研究COVID-19疫苗加强剂次的效果及接种后的细胞免疫作用。
Recipients after hematopoietic stem cell transplantation (HSCT) or chimeric antigen receptor T-cell (CAR-T) therapy are at increased risk for unfavorable outcomes after SARS-CoV-2 infection. The efficacy of COVID-19 vaccines remains undetermined in this vulnerable population, we therefore conducted a pooled analysis to evaluate the immune response after vaccination. A total of 46 studies were finally included, comprising 4757 HSCT and 174 CAR-T recipients. Our results indicated that HSCT and CAR-T recipients had an attenuated immune response to SARS-CoV-2 vaccination compared with healthy individuals, while time interval between transplant and vaccination, immunosuppressive therapy (IST) and lymphocyte counts at vaccination significantly affected the humoral response in HSCT recipients. In addition, seroconversion was significantly higher in patients with BCMA-based CAR-T than those with CD19-based CAR-T. Thus, an adapted vaccination strategy for HSCT and CAR-T recipients may be required, and further research on the effect of a booster dose of COVID-19 vaccine and the role of cellular response after vaccination is warranted.
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