tetano
Editor, Senior Moderator
Front Immunol
. 2024 Dec 18:15:1510942.
doi: 10.3389/fimmu.2024.1510942. eCollection 2024. SARS-CoV-2 immune responses in patients with multiple myeloma and lenalidomide maintenance therapy
Ioana Martac[SUP] #[/SUP][SUP] 1 [/SUP], Sina A Beer[SUP] #[/SUP][SUP] 1 [/SUP], Aileen Schenk[SUP] 1 [/SUP], Osama Ahmad[SUP] 1 [/SUP], Claus-Philipp Maier[SUP] 1 2 [/SUP], Gülay Demirel[SUP] 1 [/SUP], Beate Preuß[SUP] 1 [/SUP], Reinhild Klein[SUP] 1 [/SUP], Anna M P Stanger[SUP] 1 [/SUP], Britta Besemer[SUP] 1 [/SUP], Luca Hensen[SUP] #[/SUP][SUP] 1 [/SUP], Claudia Lengerke[SUP] #[/SUP][SUP] 1 [/SUP]
Affiliations
Introduction: Multiple myeloma (MM) is an uncontrolled plasma cell proliferation in the bone marrow, leading to immune dysregulation with impaired humoral immune responses. Conversely, cellular-based responses play a vital role in MM patients. However, the extent and duration of cellular-induced protection remain unclear to date. Here, immunomodulatory drugs (IMiDs) like Lenalidomide (Lena) become interesting, as they may have stimulatory effects on T-cell functioning.
Methods: In this study we investigated immune responses elicited by COVID-19 vaccine or infection comparing 43 healthy volunteers (avg. 35y, 72.1% female, 81.4% previously COVID-19 infected), with 41 MM patients under Lena maintenance therapy (avg. 63.8y, 51.2% female, 61% previously COVID-19 infected). Humoral responses to SARS-CoV-2 spike (S), spike-RBD, and nucleocapsid (N) were measured via ELISA in subjects' plasma. Freshly isolated PBMCs, incubated with SARS-CoV-2 peptides (N, S), activation induced marker (AIM) assays and flow cytometry, allowed us to assess cellular responses (CD8[SUP]+[/SUP] T, T[SUB](F)H[/SUB]: CD4[SUP]+[/SUP] T (follicular) helper).
Results: Whereas healthy controls showed significant better humoral responses (N IgA p<0.001), T cell responses were robust in the MM group (higher S-act. T[SUB]H[/SUB], p<0.001). Stratified by COVID-19 status, the MM group showed higher N-act. T[SUB]H[/SUB] (p=0.03). These results were unchanged comparing a Lena intake with Lena break around vaccination.
Discussion: Taken together, MM patients under Lena therapy exhibit weakened antibody production but present a robust T cell response following SARS-COV-2 infection or vaccination. Our results highlight the importance of vaccination in this subgroup and moreover, argue against a Lena intake break around the time of vaccination.
Keywords: cellular immune responses; immunomodulatory therapy; lenalidomide; multiple myeloma; vaccine response.
. 2024 Dec 18:15:1510942.
doi: 10.3389/fimmu.2024.1510942. eCollection 2024. SARS-CoV-2 immune responses in patients with multiple myeloma and lenalidomide maintenance therapy
Ioana Martac[SUP] #[/SUP][SUP] 1 [/SUP], Sina A Beer[SUP] #[/SUP][SUP] 1 [/SUP], Aileen Schenk[SUP] 1 [/SUP], Osama Ahmad[SUP] 1 [/SUP], Claus-Philipp Maier[SUP] 1 2 [/SUP], Gülay Demirel[SUP] 1 [/SUP], Beate Preuß[SUP] 1 [/SUP], Reinhild Klein[SUP] 1 [/SUP], Anna M P Stanger[SUP] 1 [/SUP], Britta Besemer[SUP] 1 [/SUP], Luca Hensen[SUP] #[/SUP][SUP] 1 [/SUP], Claudia Lengerke[SUP] #[/SUP][SUP] 1 [/SUP]
Affiliations
- PMID: 39744626
- PMCID: PMC11688394
- DOI: 10.3389/fimmu.2024.1510942
Introduction: Multiple myeloma (MM) is an uncontrolled plasma cell proliferation in the bone marrow, leading to immune dysregulation with impaired humoral immune responses. Conversely, cellular-based responses play a vital role in MM patients. However, the extent and duration of cellular-induced protection remain unclear to date. Here, immunomodulatory drugs (IMiDs) like Lenalidomide (Lena) become interesting, as they may have stimulatory effects on T-cell functioning.
Methods: In this study we investigated immune responses elicited by COVID-19 vaccine or infection comparing 43 healthy volunteers (avg. 35y, 72.1% female, 81.4% previously COVID-19 infected), with 41 MM patients under Lena maintenance therapy (avg. 63.8y, 51.2% female, 61% previously COVID-19 infected). Humoral responses to SARS-CoV-2 spike (S), spike-RBD, and nucleocapsid (N) were measured via ELISA in subjects' plasma. Freshly isolated PBMCs, incubated with SARS-CoV-2 peptides (N, S), activation induced marker (AIM) assays and flow cytometry, allowed us to assess cellular responses (CD8[SUP]+[/SUP] T, T[SUB](F)H[/SUB]: CD4[SUP]+[/SUP] T (follicular) helper).
Results: Whereas healthy controls showed significant better humoral responses (N IgA p<0.001), T cell responses were robust in the MM group (higher S-act. T[SUB]H[/SUB], p<0.001). Stratified by COVID-19 status, the MM group showed higher N-act. T[SUB]H[/SUB] (p=0.03). These results were unchanged comparing a Lena intake with Lena break around vaccination.
Discussion: Taken together, MM patients under Lena therapy exhibit weakened antibody production but present a robust T cell response following SARS-COV-2 infection or vaccination. Our results highlight the importance of vaccination in this subgroup and moreover, argue against a Lena intake break around the time of vaccination.
Keywords: cellular immune responses; immunomodulatory therapy; lenalidomide; multiple myeloma; vaccine response.