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Multicenter Study
. 2021 Aug 2;11(8):138.
doi: 10.1038/s41408-021-00530-3.

The neutralizing antibody response post COVID-19 vaccination in patients with myeloma is highly dependent on the type of anti-myeloma treatment

Evangelos Terpos  1 , Maria Gavriatopoulou  2 , Ioannis Ntanasis-Stathopoulos  2 , Alexandros Briasoulis  2 , Sentiljana Gumeni  3 , Panagiotis Malandrakis  2 , Despina Fotiou  2 , Eleni-Dimitra Papanagnou  3 , Magdalini Migkou  2 , Foteini Theodorakakou  2 , Maria Roussou  2 , Evangelos Eleutherakis-Papaiakovou  2 , Nikolaos Kanellias  2 , Ioannis P Trougakos  3 , Efstathios Kastritis  2 , Meletios A Dimopoulos  2
Affiliations
Multicenter Study

The neutralizing antibody response post COVID-19 vaccination in patients with myeloma is highly dependent on the type of anti-myeloma treatment

Evangelos Terpos et al. Blood Cancer J. .

Abstract

Recent data suggest a suboptimal antibody response to COVID-19 vaccination in patients with hematological malignancies. Neutralizing antibodies (NAbs) against SARS-CoV-2 were evaluated in 276 patients with plasma cell neoplasms after vaccination with either the BNT162b2 or the AZD1222 vaccine, on days 1 (before the first vaccine shot), 22, and 50. Patients with MM (n = 213), SMM (n = 38), and MGUS (n = 25) and 226 healthy controls were enrolled in the study (NCT04743388). Vaccination with either two doses of the BNT162b2 or one dose of the AZD1222 vaccine leads to lower production of NAbs in patients with MM compared with controls both on day 22 and on day 50 (p < 0.001 for all comparisons). Furthermore, MM patients showed an inferior NAb response compared with MGUS on day 22 (p = 0.009) and on day 50 (p = 0.003). Importantly, active treatment with either anti-CD38 monoclonal antibodies (Mabs) or belantamab mafodotin and lymphopenia at the time of vaccination were independent prognostic factors for suboptimal antibody response following vaccination. In conclusion, MM patients have low humoral response following SARS-CoV-2 vaccination, especially under treatment with anti-CD38 or belamaf. This underlines the need for timely vaccination, possibly during a treatment-free period, and for continuous vigilance on infection control measures in non-responders.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Kinetics of NAbs in MM/SMM/MGUS patients compared with age- and sex-matched controls after vaccination with 2 doses of the BNT162b2 or 1 dose of the AZD1222 vaccine.
Patients had significantly lower NAbs titers on day 22 and on day 50 compared with controls.
Fig. 2
Fig. 2. Kinetics of NAbs in patients with symptomatic MM compared with age- and sex-matched controls after vaccination with 2 doses of the BNT162b2 or 1 dose of the AZD1222 vaccine.
Patients with MM had significantly lower NAbs titers on day 22 and on day 50 compared with controls.
Fig. 3
Fig. 3. Kinetics of NAbs in MM compared with SMM and MGUS after vaccination with 2 doses of the BNT162b2 or 1 dose of the AZD1222 vaccine.
A statistically significant difference was identified both on day 22 and day 50 between the MM and MGUS group.
Fig. 4
Fig. 4. Kinetics of NAbs in symptomatic MM patients on treatment with Belantamab mafodotin or anti-CD38-based combinations compared with MM patients off treatment and MM patients on treatment with other therapeutic regimens.
Patients on Belantamab mafodotin or anti-CD38 combinations had significantly lower NAbs on day 50.
See this image and copyright information in PMC

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