Background The optimal timing of vaccination with SARS-CoV-2 vaccines after cellular therapy is incompletely understood. The objectives of this study are to determine whether humoral and cellular responses after SARS-CoV-2 vaccination differ if initiated <4 months versus 4-12 months after cellular therapy. Methods We conducted a multicenter prospective observational study at 30 cancer centers in the United States. SARS-CoV-2 vaccination was administered as part of routine care. We obtained blood prior to and after vaccinations at up to five time points and tested for SARS-CoV-2 spike (anti-S) IgG in all participants and neutralizing antibodies for Wuhan D614G, Delta B.1.617.2, and Omicron B.1.1.529 strains, as well as SARS-CoV-2-specific T cell receptors (TCRs), in a subgroup. Results We enrolled 466 allogeneic hematopoietic cell transplant (HCT; n=231), autologous HCT (n=170), and chimeric antigen receptor T cell (CAR-T cell) therapy (n=65) recipients between April 2021 and June 2022. Humoral and cellular responses did not significantly differ among participants initiating vaccinations <4 months vs 4-12 months after cellular therapy. Anti-S IgG ≥2,500 U/mL was correlated with high neutralizing antibody titers and attained by the last time point in 70%, 69%, and 34% of allogeneic HCT, autologous HCT, and CAR-T cell recipients, respectively. SARS-CoV-2-specific T cell responses were attained in 57%, 83%, and 58%, respectively. Pre-cellular therapy SARS-CoV-2 infection or vaccination were key predictors of post-cellular therapy immunity. Conclusions These data support mRNA SARS-CoV-2 vaccination prior to, and reinitiation three to four months after, cellular therapies with allogeneic HCT, autologous HCT, and CAR-T cell therapy.

中文翻译：

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造血细胞移植或嵌合抗原受体 T 细胞治疗后第一年接种 SARS-CoV-2 疫苗：一项前瞻性、多中心、观察性研究


背景 细胞治疗后接种 SARS-CoV-2 疫苗的最佳时机尚不完全清楚。本研究的目的是确定 SARS-CoV-2 疫苗接种后 <4 个月与细胞治疗后 4-12 个月开始接种后的体液和细胞反应是否有所不同。方法 我们在美国 30 个癌症中心进行了一项多中心前瞻性观察研究。 SARS-CoV-2 疫苗接种是常规护理的一部分。我们在疫苗接种前后最多五个时间点采集了血液，并测试了所有参与者的 SARS-CoV-2 刺突（抗 S）IgG 以及武汉 D614G、Delta B.1.617.2 和 Omicron B 的中和抗体。 1.1.529 株以及 SARS-CoV-2 特异性 T 细胞受体 (TCR)，属于一个亚组。结果我们在 2021 年 4 月至 2022 年 6 月期间招募了 466 名异体造血细胞移植 (HCT；n=231)、自体 HCT (n=170) 和嵌合抗原受体 T 细胞 (CAR-T 细胞) 治疗 (n=65) 的接受者。开始接种疫苗 <4 个月的参与者与细胞治疗后 4-12 个月的参与者之间的体液和细胞反应没有显着差异。抗-S IgG ≥2,500 U/mL 与高中和抗体滴度相关，并且在同种异体 HCT、自体 HCT 和 CAR-T 细胞受体的最后时间点分别有 70%、69% 和 34% 达到该水平。 SARS-CoV-2 特异性 T 细胞反应分别达到 57%、83% 和 58%。细胞治疗前 SARS-CoV-2 感染或疫苗接种是细胞治疗后免疫力的关键预测因素。结论 这些数据支持在同种异体 HCT、自体 HCT 和 CAR-T 细胞疗法之前进行 mRNA SARS-CoV-2 疫苗接种，并在三到四个月后重新开始。