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COVID-19 mRNA Vaccine in Patients With Lymphoid Malignancy or Anti-CD20 Antibody Therapy: A Systematic Review and Meta-Analysis.
Ito, Yusuke; Honda, Akira; Kurokawa, Mineo.
  • Ito Y; Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address: yuusuitou-tky@umin.ac.jp.
  • Honda A; Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Kurokawa M; Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, Tokyo, Japan.
Clin Lymphoma Myeloma Leuk ; 22(8): e691-e707, 2022 08.
Article in English | MEDLINE | ID: covidwho-1763646
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).
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Lymphoma, Non-Hodgkin / Leukemia, Lymphocytic, Chronic, B-Cell / COVID-19 Type of study: Randomized controlled trials / Reviews / Systematic review Topics: Vaccines Limits: Humans Language: English Journal: Clin Lymphoma Myeloma Leuk Journal subject: Neoplasms Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Lymphoma, Non-Hodgkin / Leukemia, Lymphocytic, Chronic, B-Cell / COVID-19 Type of study: Randomized controlled trials / Reviews / Systematic review Topics: Vaccines Limits: Humans Language: English Journal: Clin Lymphoma Myeloma Leuk Journal subject: Neoplasms Year: 2022 Document Type: Article