Tesis

Respons Antibodi terhadap Vaksin COVID-19 pada Pasien Leukemia dan Limfoma dan Faktor-faktor yang Memengaruhinya = Antibody Response to COVID-19 Vaccine in Patients with Leukemia and Lymphoma and Factors Influencing It.

Latar Belakang: Pasien dengan keganasan hematologi memiliki angka morbiditas dan mortalitas yang tinggi terhadap infeksi COVID-19. Respons vaksinasi yang lebih rendah dibandingkan populasi normal menyebabkan pemberian vaksin pada pasien dengan keganasan hematologi perlu menjadi perhatian khusus. Tujuan: Mengetahui respons antibodi anti IgG S-RBD dan neutralizing antibody (NAb) serta hubungan antara usia, jenis kelamin, status vaksinasi, platform vaksin, penyakit komorbid, dan riwayat terinfeksi dengan respons antibodi IgG S-RBD dan NAb terhadap vaksin COVID-19 pada pasien leukemia dan limfoma. Metode: Penelitian menggunakan desain cross sectional terhadap 103 orang pasien leukemia dan limfoma di Poliklinik Hematologi Onkologi Medik Penyakit Dalam RSUPN Dr. Cipto Mangunkusumo. Subjek penelitian diambil secara konsekutif, merupakan pasien yang sudah mendapatkan vaksinasi COVID-19 minimal sebanyak dua dosis dan tidak mendapatkan kemoterapi intravena dalam waktu enam bulan terakhir. Subjek mengisi kuesioner dan menjalani pemeriksaan antibodi IgG S-RBD dan NAb. Hasil: Tingkat serokonversi antibodi IgG S-RBD sebesar 83,50% dan NAb 100%. Usia, jenis kelamin, status vaksinasi, penyakit komorbid, dan riwayat terinfeksi tidak berhubungan dengan respons antibodi terhadap vaksin COVID-19. Pemberian vaksin inactivated sebagai vaksin primer menghasilkan risiko seronegatif lebih rendah dibandingkan vaksin mRNA terhadap antibodi IgG S-RBD. Pemberian vaksin vektor virus sebagai vaksin dosis ketiga menghasilkan risiko seronegatif lebih tinggi dibandingkan vaksin mRNA terhadap antibodi IgG S-RBD. Simpulan: Pasien dengan leukemia dan limfoma yang tidak menjalani kemoterapi intravena selama enam bulan memberikan hasil serokonversi yang tinggi terhadap vaksin COVID-19. Platform vaksin memengaruhi serokonversi terhadap antibodi IgG S-RBD.
Kata kunci: serokonversi, vaksin, COVID-19, leukemia, limfoma, antibodi IgG SRBD, neutralizing antibody.


Background: Patients with hematologic malignancies have high morbidity and mortality rates from COVID-19 infection. The lower vaccine response compared to the general population makes vaccine administration in patients with hematologic malignancies a particular concern. Objective: To determine the S-RBD IgG antibody and neutralizing antibody (NAb) responses and the relationship between age, sex, vaccination status, vaccine platform, comorbidities, and history of infection with S-RBD IgG antibody and NAb responses to the COVID-19 vaccine in leukemia and lymphoma patients. Methods: The study used a cross-sectional design of 103 leukemia and lymphoma patients at the Hematology Oncology Internal Medicine Polyclinic of Cipto Mangunkusumo National General Hospital. The subjects were enrolled consecutively, were patients who had received at least two doses of COVID-19 vaccination and had not received intravenous chemotherapy within the previous six months. Subjects completed a questionnaire and underwent testing for S-RBD IgG antibody and NAb levels. Results: The seroconversion rate of S-RBD IgG antibodies was 83.50% and NAb 100%. Age, sex, vaccination status, comorbid diseases, and history of infection were not associated with antibody responses to COVID-19 vaccines. Administration of inactivated vaccines as primary vaccines results in a lower seronegative risk than mRNA vaccines against S-RBD IgG antibodies. Administration of viral vector vaccines as a third dose of vaccine results in a higher seronegative risk than mRNA vaccines against S-RBD IgG antibodies. Conclusions: Patients with leukemia and lymphoma who had not received intravenous chemotherapy for six months had high seroconversion rates to COVID-19 vaccines. The vaccine platform affects seroconversion to S-RBD IgG antibodies.
Keywords: seroconversion, vaccine, COVID-19, leukemia, lymphoma, S-RBD IgG antibody, neutralizing antibody.