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Immunogenicity of COVID-19 vaccines in patients with hematologic malignancies: a systematic review and meta-analysis.
Teh, Joanne S K; Coussement, Julien; Neoh, Zoe C F; Spelman, Tim; Lazarakis, Smaro; Slavin, Monica A; Teh, Benjamin W.
  • Teh JSK; Department of Infectious Diseases.
  • Coussement J; National Centre for Infections in Cancer, and.
  • Neoh ZCF; Department of Infectious Diseases.
  • Spelman T; National Centre for Infections in Cancer, and.
  • Lazarakis S; Department of Infectious Diseases.
  • Slavin MA; National Centre for Infections in Cancer, and.
  • Teh BW; Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Blood Adv ; 6(7): 2014-2034, 2022 04 12.
Article in English | MEDLINE | ID: covidwho-1765426
ABSTRACT
The objectives of this study were to assess the immunogenicity and safety of COVID-19 vaccines in patients with hematologic malignancies. A systematic review and meta-analysis of clinical studies of immune responses to COVID-19 vaccination stratified by underlying malignancy and published from January 1, 2021, to August 31, 2021, was conducted using MEDLINE, EMBASE, and Cochrane CENTRAL. Primary outcome was the rate of seropositivity after 2 doses of COVID-19 vaccine with rates of seropositivity after 1 dose, rates of positive neutralizing antibodies, cellular responses, and adverse events as secondary outcomes. Rates were pooled from single-arm studies while rates of seropositivity were compared against the rate in healthy controls for comparator studies using a random effects model and expressed as a pooled odds ratios with 95% confidence intervals. Forty-four studies (16 mixed group, 28 disease specific) with 7064 patients were included in the analysis (2331 after first dose, 4733 after second dose). Overall seropositivity rates were 62% to 66% after 2 doses of COVID-19 vaccine and 37% to 51% after 1 dose. The lowest seropositivity rate was 51% in patients with chronic lymphocytic leukemia and was highest in patients with acute leukemia (93%). After 2 doses, neutralizing antibody response rates were 57% to 60%, and cellular response rates were 40% to 75%. Active treatment, ongoing or recent treatment with targeted and CD-20 monoclonal antibody therapies within 12 months were associated with poor immune responses to COVID-19 vaccine. New approaches to prevention are urgently required to reduce COVID-19 infection morbidity and mortality in high-risk patient groups that respond poorly to COVID-19 vaccination.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hematologic Neoplasms / COVID-19 Type of study: Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid / Vaccines Limits: Humans Language: English Journal: Blood Adv Year: 2022 Document Type: Article Affiliation country: Bloodadvances.2021006333

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hematologic Neoplasms / COVID-19 Type of study: Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid / Vaccines Limits: Humans Language: English Journal: Blood Adv Year: 2022 Document Type: Article Affiliation country: Bloodadvances.2021006333