Efficacy of anti-severe acute respiratory syndrome coronavirus 2 mRNA vaccines in adults with severe acquired aplastic anemia with or without allogeneic hematopoietic stem cell transplantation

[摘要] Vaccines against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) have shown remarkable efficacy and thus constitutean important preventive option against coronavirus disease 2019(COVID-19) infections, especially in immunocompromised hosts. Several studies have now demonstrated a good response to SARS-CoV-2mRNA vaccines in allogeneic hematopoietic stem cell transplant (AlloHSCT) recipients [1–3]. Aplastic anemia (AA) [4] represents anotherimmunocompromised situation. Surprisingly, the incidence of COVID19 infection in this setting appears to be relatively low (2.5%–13%)[5, 6], despite most patients being still on immunotherapy. This couldbe related to favorable host factors, such as young age, or be secondaryto some protective immune dysregulation known to be present in AA[7]. In a recent study of 23 non-vaccinated AA patients, including sevenwith a previous Allo-HSCT, 29% had to be hospitalized after COVID19 infection, one died and 65% showed a decline in blood parameterswith worsening of cytopenias and increasing need for transfusions.

[关键词] allogeneic;aplastic anemia;BNT162b2;COVID-19;SARS-CoV-2 mRNA;third dose;vaccine