Abstract
Background: 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.
Materials and methods: A literature search retrieved 52 relevant articles, and random-effect models were used to analyze humoral and cellular responses.
Results: 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.
Conclusion: 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).
Keywords: B-cell target therapy; CLL; Cellular response; Humoral response; Seropositivity.
【저자키워드】 Humoral response, CLL, seropositivity., cellular response, B-cell target therapy, 【초록키워드】 COVID-19, Meta-analysis, Vaccine, vaccination, therapy, antibody, mRNA vaccine, chronic lymphocytic leukemia, systematic review, risk, mRNA vaccines, T cell, Myeloma, Humoral response, lymphoma, T cell responses, Patient, Effectiveness, Seropositivity, leukemia, anti-CD20, B-cell, cellular response, risk ratio, Long-term follow-up, malignancy, humoral, COVID-19 mRNA vaccine, Cellular responses, Humoral and cellular responses, independent of, registration number, within 6 months, COVID-19 mRNA vaccines, These data, individual, malignancies, Lymphocytic leukemia, material, lymphoid, subtype, articles, independent, PROTECT, significantly, exhibited, were used, attenuate, response to vaccination, retrieved, 【제목키워드】 COVID-19, review, mRNA,