Vaccination against Coronavirus disease-19(COVID-19)was pivotal to limit spread,morbidity and mortality.Our aim is to find out whether vaccines against COVID-19 lead to an immunological response stimulating the produc...Vaccination against Coronavirus disease-19(COVID-19)was pivotal to limit spread,morbidity and mortality.Our aim is to find out whether vaccines against COVID-19 lead to an immunological response stimulating the production of de novo donor specific antibodies(DSAs)or increase in mean fluorescence intensity(MFI)of pre-existing DSAs in kidney transplant recipients(KTRs).This study involved a detailed literature search through December 2nd,2023 using PubMed as the primary database.The search strategy incorporated a combination of relevant Medical Subject Headings terms and keywords:"COVID-19","SARS-CoV-2 Vaccination","Kidney,Renal Transplant",and"Donor specific antibodies".The results from related studies were collated and analyzed.A total of 6 studies were identified,encompassing 460 KTRs vaccinated against COVID-19.Immunological responses were detected in 8 KTRs of which 5 had increased MFIs,1 had de novo DSA,and 2 were categorized as either having de novo DSA or increased MFI.There were 48 KTRs with pre-existing DSAs prior to vaccination,but one study(Massa et al)did not report whether pre-existing DSAs were associated with post vaccination outcomes.Of the remaining 5 studies,35 KTRs with pre-existing DSAs were identified of which 7 KTRs(20%)developed de novo DSAs or increased MFIs.Overall,no immunological response was detected in 452(98.3%)KTRs.Our study affirms prior reports that COVID-19 vaccination is safe for KTRs,especially if there are no pre-existing DSAs.However,if KTRs have pre-existing DSAs,then an increased immunological risk may be present.These findings need to be taken cautiously as they are based on a limited number of patients so further studies are still needed for confirmation.展开更多
目的:比较曲妥珠单抗和帕妥珠单抗(trastuzumab plus pertuzumab,HP)联合紫杉类+铂类(TCbHP)、紫杉类单药(THP)、蒽环类序贯紫杉类(AC-THP)三种化疗方案在真实世界临床实践中新辅助治疗HER-2阳性乳腺癌的疗效、安全性及耐受性。方法:回...目的:比较曲妥珠单抗和帕妥珠单抗(trastuzumab plus pertuzumab,HP)联合紫杉类+铂类(TCbHP)、紫杉类单药(THP)、蒽环类序贯紫杉类(AC-THP)三种化疗方案在真实世界临床实践中新辅助治疗HER-2阳性乳腺癌的疗效、安全性及耐受性。方法:回顾性分析2019年6月至2021年12月于保定市第一中心医院等河北省共11家三级甲等医院接受三种方案新辅助治疗并完成后续手术的180例HER-2阳性乳腺癌患者的临床病理资料,其中TCbHP组78例、THP组70例、AC-THP组32例,比较三种治疗方案的疗效、安全性及耐受性,并采用统计学方法分析临床病理因素对总体病理完全缓解(total pathologic complete response,tpCR)率的影响。结果:总人群tpCR率为58.9%(106/180)。TCbHP组的tpCR率为64.1%(50/78),高于THP组的54.3%(38/70)和AC-THP组的56.3%(18/32),差异无统计学意义(P=0.454)。TCbHP组的3级及以上不良反应发生率为12.8%(10/78),高于THP组的4.3%(3/70)和AC-THP组的9.4%(3/32),差异无统计学意义(P=0.255)。THP组的既定方案完成率为98.6%(69/70),高于TCbHP组的92.3%(72/78)和AC-THP组的90.6%(29/32),差异无统计学意义(P=0.147)。180例患者中绝经后组与绝经前组的tpCR率分别为65.4%(70/107)与49.3%(36/73),HER-2免疫组织化学法(IHC)3+组与HER-2 IHC2+且荧光原位杂交(FISH)+组的tpCR率分别为65.0%(102/157)与17.4%(4/23),激素受体(HR)阴性组与HR阳性组的tpCR率分别为78.0%(64/82)与42.9%(42/98),白蛋白结合型紫杉醇组与其他紫杉类药物组的tpCR率分别为66.3%(65/98)与50.0%(41/82),组间进行比较差异均具有统计学意义(均P<0.05)。Logistic回归多因素分析表明,HER-2 IHC3+、HR阴性、使用白蛋白结合型紫杉醇为tpCR率的独立影响因素。结论:TCbHP、THP、AC-THP方案新辅助治疗HER-2阳性乳腺癌在真实世界临床实践中疗效确切,安全性及耐受性良好。TCbHP方案可考虑作为HER-2阳性乳腺癌新辅助治疗的优选方案。展开更多
文摘Vaccination against Coronavirus disease-19(COVID-19)was pivotal to limit spread,morbidity and mortality.Our aim is to find out whether vaccines against COVID-19 lead to an immunological response stimulating the production of de novo donor specific antibodies(DSAs)or increase in mean fluorescence intensity(MFI)of pre-existing DSAs in kidney transplant recipients(KTRs).This study involved a detailed literature search through December 2nd,2023 using PubMed as the primary database.The search strategy incorporated a combination of relevant Medical Subject Headings terms and keywords:"COVID-19","SARS-CoV-2 Vaccination","Kidney,Renal Transplant",and"Donor specific antibodies".The results from related studies were collated and analyzed.A total of 6 studies were identified,encompassing 460 KTRs vaccinated against COVID-19.Immunological responses were detected in 8 KTRs of which 5 had increased MFIs,1 had de novo DSA,and 2 were categorized as either having de novo DSA or increased MFI.There were 48 KTRs with pre-existing DSAs prior to vaccination,but one study(Massa et al)did not report whether pre-existing DSAs were associated with post vaccination outcomes.Of the remaining 5 studies,35 KTRs with pre-existing DSAs were identified of which 7 KTRs(20%)developed de novo DSAs or increased MFIs.Overall,no immunological response was detected in 452(98.3%)KTRs.Our study affirms prior reports that COVID-19 vaccination is safe for KTRs,especially if there are no pre-existing DSAs.However,if KTRs have pre-existing DSAs,then an increased immunological risk may be present.These findings need to be taken cautiously as they are based on a limited number of patients so further studies are still needed for confirmation.
