Reducedhumoral response against variants of concern in childhood solid cancer patients compared to adult patients and healthy children after SARS-CoV-2 vaccination

Frontiers in Immunology

Immunology

Yanqi Wang¹  Zhiying Zhang¹  Guangzhen Fu²  Pengfei Zhu³  Xiaolong Wei⁴  Youlong Wang⁴  Shenrui Bai⁵  Yifei Ma⁶  Xinjia Wang⁶  Shuqin Chen⁷  Jun Lv⁷  Dao Wang⁸  Lu Cao⁸  Guanqing Zhong⁹  Nianqi Liu⁹  Ao Zhang⁹  Bocen Chen^1,10 

[1] Department of Bone and Soft Tissue Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China;School of Public Health, Shantou University, Shantou, Guangdong Province, China;Department of Clinical Laboratory, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China;Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China;Department of General Surgery, Hainan Hospital of People's Liberation Army General Hospital, Sanya, Hainan, China;Department of Hematological Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China;Department of Orthopedics and Spine Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China;Department of Bone and Soft Tissue Oncology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China;Department of Pathology, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China;Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China;Faculty of Psychology, Institute of Educational Science, Huazhong University of Science and Technology, Wuhan, Hubei, China;Key Laboratory of Biochemistry and Molecular Biology, Hainan Medical University, Haikou, Hainan, China;

关键词: SARS-CoV-2;    childhood cancer patients;    variants of concern;    immune response;    propensity score matching;   

DOI  :  10.3389/fimmu.2023.1110755

 received in 2022-11-29, accepted in 2023-04-03,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionAlthough there is extended research on the response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in adult cancer patients (ACP), the immunogenicity to the variants of concern (VOCs) in childhood cancer patients (CCP) and safety profiles are now little known.MethodsA prospective, multi-center cohort study was performed by recruiting children with a solid cancer diagnosis and childhood healthy control (CHC) to receive standard two-dose SARS-CoV-2 vaccines. An independent ACP group was included to match CCP in treatment history. Humoral response to six variants was performed and adverse events were followed up 3 months after vaccination. Responses to variants were compared with ACP and CHC by means of propensity score-matched (PSM) analysis.ResultsThe analysis included 111 CCP (27.2%, median age of 8, quartile 5.5–15 years), 134 CHC (32.8%), and 163 ACP (40.0%), for a total 408 patients. Pathology included carcinoma, neural tumors, sarcoma, and germ cell tumors. Median chemotherapy time was 7 (quartile, 5–11) months. In PSM sample pairs, the humoral response of CCP against variants was significantly decreased, and serology titers (281.8 ± 315.5 U/ml) were reduced, as compared to ACP (p< 0.01 for the rate of neutralization rate against each variant) and CHC (p< 0.01 for the rate of neutralization against each variant) groups. Chemotherapy time and age (Pearson r ≥ 0.8 for all variants) were associated with the humoral response against VOCs of the CHC group. In the CCP group, less than grade II adverse events were observed, including 32 patients with local reactions, and 29 patients had systemic adverse events, including fever (n = 9), rash (n = 20), headache (n = 3), fatigue (n = 11), and myalgia (n = 15). All reactions were well-managed medically.ConclusionsThe humoral response against VOCs after the CoronaVac vaccination in CCP was moderately impaired although the vaccine was safe. Age and chemotherapy time seem to be the primary reason for poor response and low serology levels.

【 授权许可】

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Copyright © 2023 Ma, Chen, Wang, Zhu, Liu, Zhang, Zhong, Fu, Wang, Cao, Bai, Wang, Chen, Wei, Lv, Zhang and Wang