Efficacy of covid-19 vaccines in immunocompromised patients: systematic review and meta-analysis

BMJ, Год журнала: 2022, Номер unknown, С. e068632 - e068632

Опубликована: Март 2, 2022

Abstract Objective To compare the efficacy of covid-19 vaccines between immunocompromised and immunocompetent people. Design Systematic review meta-analysis. Data sources PubMed, Embase, Central Register Controlled Trials, COVID-19 Open Research Dataset Challenge (CORD-19), WHO databases for studies published 1 December 2020 5 November 2021. ClinicalTrials.gov International Clinical Trials Registry Platform were searched in 2021 to identify registered but as yet unpublished or ongoing studies. Study selection Prospective observational comparing vaccination participants. Methods A frequentist random effects meta-analysis was used separately pool relative absolute risks seroconversion after first second doses a vaccine. without SARS-CoV-2 antibody titre levels performed first, second, third vaccine rate dose. Risk bias certainty evidence assessed. Results 82 included Of these studies, 77 (94%) mRNA vaccines, 16 (20%) viral vector 4 (5%) inactivated whole virus vaccines. 63 assessed be at low risk 19 moderate bias. After one dose, about half likely patients with haematological cancers (risk ratio 0.40, 95% confidence interval 0.32 0.50, I 2 =80%; 0.29, 0.20 =89%), immune mediated inflammatory disorders (0.53, 0.39 0.71, =89%; 0.11 0.58, =97%), solid (0.55, 0.46 0.65, =78%; 0.44, 0.36 0.53, =84%) compared controls, whereas organ transplant recipients times less seroconvert (0.06, 0.04 0.09, =0%; 0.06, 0.08, =0%). remained least (0.39, 0.46, =92%; 0.35, 0.26 0.46), only achieving seroconversion. Seroconversion increasingly (0.63, 0.57 0.69, =88%; 0.62, 0.54 0.70, =90%), (0.75, 0.69 0.82, 0.77, 0.66 0.85, =93%), (0.90, 0.88 0.93, =51%; 0.89, 0.86 0.91, =49%). similar people HIV controls (1.00, 0.98 1.01, 0.97, 0.83 1.00, =89%). 11 showed that dose associated among non-responders cancers, disorders, although response variable inadequately studied those receiving non-mRNA Conclusion rates significantly lower patients, especially recipients. consistently improved across all patient groups, albeit magnitude Targeted interventions including (booster) should performed. registration PROSPERO CRD42021272088.

Язык: Английский

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COVID-19 in patients with hematologic malignancy

Blood, Год журнала: 2022, Номер 140(3), С. 236 - 252

Опубликована: Май 11, 2022

Язык: Английский

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Mantle cell lymphoma in 2022—A comprehensive update on molecular pathogenesis, risk stratification, clinical approach, and current and novel treatments

American Journal of Hematology, Год журнала: 2022, Номер 97(5), С. 638 - 656

Опубликована: Март 10, 2022

The field of mantle cell lymphoma (MCL) has witnessed remarkable progress due to relentless advances in molecular pathogenesis, prognostication, and newer treatments. MCL consists a spectrum clinical subtypes. Rarely, atypical cyclin D1-negative situ neoplasia are identified. Prognostication is further refined by identifying somatic mutations (such as TP53, NSD2, KMT2D), methylation status, chromatin organization pattern, SOX-11 expression, minimal residual disease (MRD), genomic clusters. Lymphoid tissue microenvironment studies demonstrated the role B-cell receptor signaling, nuclear factor kappa B (NF-kB), colony-stimulating (CSF)-1, CD70-SOX-11 axis. Molecular mechanism resistance, mutation dynamics, pathogenic pathways (B-cell (BCR), oxidative phosphorylation, MYC) were identified mediating resistance various treatments (bruton tyrosine kinase (BTK) inhibitors [ibrutinib, acalabrutinib]. Treatment options range from conventional chemoimmunotherapy stem transplantation (SCT) targeted therapies against BTK (covalent noncovalent), Bcl2, ROR1, cellular therapy such anti-CD19 chimeric antigen (CAR-T), most recently bispecific antibodies CD19 CD20. patients frequently relapse. Complex pathogenesis management with progression after treatment BTK/Bcl2 CAR-T (triple-resistant MCL) remain challenge. Next-generation trials incorporating agents concurrent translational investigations ongoing.

Язык: Английский

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Breakthrough COVID-19 in vaccinated patients with hematologic malignancies: results from the EPICOVIDEHA survey

Blood, Год журнала: 2022, Номер 140(26), С. 2773 - 2787

Опубликована: Сен. 20, 2022

Limited data are available on breakthrough COVID-19 in patients with hematologic malignancy (HM) after anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. Adult HM, ≥1 dose of anti-SARS-CoV-2 vaccine, and between January 2021 March 2022 were analyzed. A total 1548 cases included, mainly lymphoid malignancies (1181 cases, 76%). After viral sequencing 753 (49%), the Omicron variant was prevalent (517, 68.7%). Most received ≤2 vaccine doses before (1419, 91%), mostly mRNA-based (1377, 89%). Overall, 906 (59%) COVID-19-specific treatment. 30-day follow-up from diagnosis, 143 (9%) died. The mortality rate 7.9%, comparable to other variants, a significantly lower than prevaccine era (31%). In univariable analysis, older age (P < .001), active HM severe critical = .007 P .001, respectively) associated mortality. Conversely, receiving monoclonal antibodies, even for or COVID-19, had .001). multivariable model, age, disease, 2-3 comorbidities correlated higher mortality, whereas antibody administration, alone .001) combined antivirals .009), protective. Although is prevaccination era, still considerable Death who combination antivirals.

Язык: Английский

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Efficacy of booster doses in augmenting waning immune responses to COVID-19 vaccine in patients with cancer

Cancer Cell, Год журнала: 2021, Номер 40(1), С. 3 - 5

Опубликована: Ноя. 16, 2021

Язык: Английский

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COVID-19 mRNA booster vaccines elicit strong protection against SARS-CoV-2 Omicron variant in patients with cancer

Cancer Cell, Год журнала: 2021, Номер 40(2), С. 117 - 119

Опубликована: Дек. 30, 2021

Язык: Английский

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Effectiveness of the BNT162b2mRNA COVID-19 vaccine in patients with hematological neoplasms in a nationwide mass vaccination setting

Blood, Год журнала: 2021, Номер 139(10), С. 1439 - 1451

Опубликована: Окт. 20, 2021

Язык: Английский

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Humoral Responses Against SARS-CoV-2 and Variants of Concern After mRNA Vaccines in Patients With Non-Hodgkin Lymphoma and Chronic Lymphocytic Leukemia

Journal of Clinical Oncology, Год журнала: 2022, Номер 40(26), С. 3020 - 3031

Опубликована: Апрель 18, 2022

Patients with non-Hodgkin lymphoma including chronic lymphocytic leukemia (NHL/CLL) are at higher risk of severe SARS-CoV-2 infection. We investigated vaccine-induced antibody responses in patients NHL/CLL against the original strain and variants concern B.1.167.2 (Delta) B.1.1.529 (Omicron).

Язык: Английский

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Association of COVID-19 Vaccination With Breakthrough Infections and Complications in Patients With Cancer

JAMA Oncology, Год журнала: 2022, Номер 9(3), С. 386 - 386

Опубликована: Дек. 29, 2022

Patients with cancer are known to have increased risk of COVID-19 complications, including death.To determine the association vaccination breakthrough infections and complications in patients compared noncancer controls.Retrospective population-based cohort study using linked administrative databases Ontario, Canada, residents 18 years older who received vaccination. Three matched groups were identified (based on age, sex, type vaccine, date vaccine): 1:4 match for hematologic solid controls (hematologic cancers separately analyzed), 1:1 between cancer.Cancer diagnosis.Outcomes occurring 14 days after receipt second dose: primary outcome was SARS-CoV-2 infection; secondary outcomes emergency department visit, hospitalization, death within 4 weeks infection (end follow-up March 31, 2022). Multivariable cumulative incidence function models used obtain adjusted hazard ratio (aHR) 95% CIs.A total 289 400 vaccinated (39 880 hematologic; 249 520 solid) 1 157 600 identified; 65.4% female, mean (SD) age 66 (14.0) years. higher (aHR, 1.33; CI, 1.20-1.46; P < .001) but not 1.00; 0.96-1.05; = .87). severe (composite hospitalization death) significantly without 1.52; 1.42-1.63; .001). Risk among 2.51; 2.21-2.85; than 1.43; 1.24-1.64; receiving active treatment had a further heightened outcomes, particularly those anti-CD20 therapy. Third dose associated lower except therapy.In this large study, greater worse cancer, highest any treatment. Triple poor outcomes.

Язык: Английский

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mRNA COVID-19 vaccine booster fosters B- and T-cell responses in immunocompromised patients

Life Science Alliance, Год журнала: 2022, Номер 5(6), С. e202201381 - e202201381

Опубликована: Фев. 15, 2022

SARS-CoV-2 vaccination has proven effective in inducing an immune response healthy individuals and is progressively us allowing to overcome the pandemic. Recent evidence shown that some vulnerable patients may be diminished, it been proposed a booster dose. We tested kinetic of development serum antibodies Spike protein, their neutralizing capacity, CD4 CD8 IFN-γ T-cell 328 subjects, including 131 immunocompromised (cancer, rheumatologic, hemodialysis patients), 160 health-care workers (HCW) 37 subjects older than 75 yr, after with two or three doses mRNA vaccines. stratified according type treatment. found patients, depending on treatment, poorly respond However, additional dose vaccine induced good almost all except those receiving anti-CD20 antibody. Similarly HCW, previously infected vaccinated demonstrate stronger SARS-CoV-2–specific who are without prior infection.

Язык: Английский

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