RESUMO
Patients with blood cancer continue to have a greater risk of inadequate immune responses following three COVID-19 vaccine doses and risk of severe COVID-19 disease. In the context of the CAPTURE study (NCT03226886), we report immune responses in 80 patients with blood cancer who received a fourth dose of BNT162b2. We measured neutralizing antibody titers (NAbTs) using a live virus microneutralization assay against wild-type (WT), Delta, and Omicron BA.1 and BA.2 and T cell responses against WT and Omicron BA.1 using an activation-induced marker (AIM) assay. The proportion of patients with detectable NAb titers and T cell responses after the fourth vaccine dose increased compared with that after the third vaccine dose. Patients who received B cell-depleting therapies within the 12 months before vaccination have the greatest risk of not having detectable NAbT. In addition, we report immune responses in 57 patients with breakthrough infections after vaccination.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Neoplasias , Humanos , Anticorpos Neutralizantes , Anticorpos Antivirais , Vacina BNT162 , Estudos Clínicos como Assunto , COVID-19/prevenção & controle , Vacinas contra COVID-19/imunologia , Imunidade , SARS-CoV-2Assuntos
Anticorpos Neutralizantes/biossíntese , Anticorpos Antivirais/biossíntese , Vacinas contra COVID-19/imunologia , COVID-19/prevenção & controle , Neoplasias Hematológicas/imunologia , Imunização Secundária , SARS-CoV-2/imunologia , Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , COVID-19/complicações , COVID-19/epidemiologia , Neoplasias Hematológicas/complicações , Humanos , Imunogenicidade da Vacina , Neoplasias/complicações , Neoplasias/imunologia , Avaliação de SintomasRESUMO
CAPTURE (NCT03226886) is a prospective cohort study of COVID-19 immunity in patients with cancer. Here we evaluated 585 patients following administration of two doses of BNT162b2 or AZD1222 vaccines, administered 12 weeks apart. Seroconversion rates after two doses were 85% and 59% in patients with solid and hematological malignancies, respectively. A lower proportion of patients had detectable neutralizing antibody titers (NAbT) against SARS-CoV-2 variants of concern (VOCs) vs wildtype (WT). Patients with hematological malignancies were more likely to have undetectable NAbT and had lower median NAbT vs solid cancers against both WT and VOCs. In comparison with individuals without cancer, patients with haematological, but not solid, malignancies had reduced NAb responses. Seroconversion showed poor concordance with NAbT against VOCs. Prior SARS-CoV-2 infection boosted NAb response including against VOCs, and anti-CD20 treatment was associated with undetectable NAbT. Vaccine-induced T-cell responses were detected in 80% of patients, and were comparable between vaccines or cancer types. Our results have implications for the management of cancer patients during the ongoing COVID-19 pandemic.
Assuntos
Imunidade Adaptativa/imunologia , Anticorpos Neutralizantes/imunologia , Vacinas contra COVID-19/imunologia , COVID-19/imunologia , Carcinoma de Células Renais/complicações , Neoplasias Renais/complicações , SARS-CoV-2/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Vacina BNT162/administração & dosagem , Vacina BNT162/imunologia , COVID-19/complicações , COVID-19/epidemiologia , Vacinas contra COVID-19/administração & dosagem , ChAdOx1 nCoV-19/administração & dosagem , ChAdOx1 nCoV-19/imunologia , Feminino , Humanos , Imunogenicidade da Vacina/imunologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Estudos Prospectivos , SARS-CoV-2/genética , SARS-CoV-2/fisiologia , Linfócitos T/imunologia , Linfócitos T/virologia , Vacinação/métodosRESUMO
Coronavirus disease 2019 (COVID-19) antiviral response in a pan-tumor immune monitoring (CAPTURE) ( NCT03226886 ) is a prospective cohort study of COVID-19 immunity in patients with cancer. Here we evaluated 585 patients following administration of two doses of BNT162b2 or AZD1222 vaccines, administered 12 weeks apart. Seroconversion rates after two doses were 85% and 59% in patients with solid and hematological malignancies, respectively. A lower proportion of patients had detectable titers of neutralizing antibodies (NAbT) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOC) versus wild-type (WT) SARS-CoV-2. Patients with hematological malignancies were more likely to have undetectable NAbT and had lower median NAbT than those with solid cancers against both SARS-CoV-2 WT and VOC. By comparison with individuals without cancer, patients with hematological, but not solid, malignancies had reduced neutralizing antibody (NAb) responses. Seroconversion showed poor concordance with NAbT against VOC. Previous SARS-CoV-2 infection boosted the NAb response including against VOC, and anti-CD20 treatment was associated with undetectable NAbT. Vaccine-induced T cell responses were detected in 80% of patients and were comparable between vaccines or cancer types. Our results have implications for the management of patients with cancer during the ongoing COVID-19 pandemic.
Assuntos
Vacina BNT162/imunologia , COVID-19/prevenção & controle , ChAdOx1 nCoV-19/imunologia , Neoplasias/imunologia , SARS-CoV-2/imunologia , Idoso , Anticorpos Neutralizantes/sangue , Anticorpos Neutralizantes/imunologia , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Vacina BNT162/administração & dosagem , COVID-19/sangue , COVID-19/imunologia , ChAdOx1 nCoV-19/administração & dosagem , Feminino , Humanos , Imunidade Celular , Imunogenicidade da Vacina , Masculino , Pessoa de Meia-Idade , Neoplasias/sangue , Neoplasias/complicações , Estudos Prospectivos , Linfócitos T/imunologiaRESUMO
The authors examined the relation between self-report psychopathy measures and official records of offending in four samples of justice-involved youth (total N = 447). Psychopathy measures included the Antisocial Process Screening Device (APSD) and a modified version of the Childhood Psychopathy Scale (mCPS). Measures of offending included the total number of preadmission arrest charges for three samples (n = 392) and the total number of offenses in the year following release for two samples (n = 138). Neither measure was a strong correlate of preadmission offenses. Although mCPS scores were associated with postrelease offending in one sample, effects for the APSD were observed only when reoffending was conceptualized as a dichotomous variable, indicating a lack of robustness in this association. The findings suggest caution in the use of self-report measures of psychopathic features for decision making with respect to issues of delinquency risk among justice-involved youth.
Assuntos
Transtorno da Personalidade Antissocial/diagnóstico , Transtornos do Comportamento Infantil/psicologia , Delinquência Juvenil/psicologia , Autorrevelação , Adolescente , Psiquiatria do Adolescente , Criança , Psiquiatria Infantil , Humanos , MasculinoRESUMO
The validity of the 28-item version of the General Health Questionnaire (GHQ-28) was determined by comparison with the Clinical Interview Schedule (CIS) in 56 pain clinic patients. Despite some limitations, the GHQ can be used effectively and cheaply as the first stage of an assessment to identify potential "cases" of mental disorder which must then be verified using a second-stage clinical interview such as the CIS. This process can result in a considerable reduction in the proportion of patients requiring a psychiatric interview and, therefore, in reduced service costs. Factors associated with lower validity coefficients include female sex, age above 60 years and pain with a duration of less than 2 years.