tetano
Editor, Senior Moderator
Int J Hematol
. 2022 Feb 21.
doi: 10.1007/s12185-022-03300-4. Online ahead of print.
Low clinical protective response to SARS-CoV-2 mRNA COVID-19 vaccine in patients with multiple myeloma
Toshiki Terao[SUP] #[/SUP][SUP] 1 [/SUP], Takeshi Yamashita[SUP] #[/SUP][SUP] 2 3 [/SUP], Ami Fukumoto[SUP] 1 [/SUP], Yuya Kamura[SUP] 1 [/SUP], Daisuke Ikeda[SUP] 1 [/SUP], Ayumi Kuzume[SUP] 1 [/SUP], Rikako Tabata[SUP] 1 [/SUP], Takafumi Tsushima[SUP] 1 [/SUP], Daisuke Miura[SUP] 1 [/SUP], Kentaro Narita[SUP] 1 [/SUP], Masami Takeuchi[SUP] 1 [/SUP], Masahiro Doi[SUP] 4 [/SUP], Yuka Umezawa[SUP] 4 [/SUP], Yoshihito Otsuka[SUP] 4 [/SUP], Hiroyuki Takamatsu[SUP] #[/SUP][SUP] 5 [/SUP], Kosei Matsue[SUP] #[/SUP][SUP] 6 [/SUP]
Affiliations
Abstract
We conducted a prospective, three-center, observational study in Japan to evaluate the prevalence of seropositivity and clinically protective titer after coronavirus disease 2019 vaccination in patients with plasma cell dyscrasia(PCD). Two-hundred sixty-nine patients with PCD [206 symptomatic multiple myeloma (MM)] were evaluated. Seropositivity was observed in 88.7% and a clinically protective titer in 38.3% of MM patients, both of which were significantly lower than those of healthy controls. Patients receiving anti-CD38 antibodies had much lower antibody titers, but antibody titers recovered in those who underwent a wash-out period before vaccine administration. Older age (≥65), anti-CD38 antibody administration, immunomodulatory drugs use, lymphopenia (<1000/μL), and lower polyclonal IgG (<550 mg/dL) had a negative impact for the sufficient antibody production according to multivariate analysis. Patients with clinically protective titer had a significantly higher number of CD19+ lymphocytes than those with lower antibody responses (114 vs. 35/μL, p = 0.016). Our results suggested that patients with PCD should be vaccinated, and that the ideal protocol is to temporarily interrupt anti-CD38 antibody therapy for a "wash-out" period of a few months, followed by a (booster) vaccine after the B-cells have recovery.
Keywords: Anti-CD38 antibody; COVID-19; Multiple myeloma; Plasma cell dyscrasia; SARS-CoV-2; mRNA vaccine.
. 2022 Feb 21.
doi: 10.1007/s12185-022-03300-4. Online ahead of print.
Low clinical protective response to SARS-CoV-2 mRNA COVID-19 vaccine in patients with multiple myeloma
Toshiki Terao[SUP] #[/SUP][SUP] 1 [/SUP], Takeshi Yamashita[SUP] #[/SUP][SUP] 2 3 [/SUP], Ami Fukumoto[SUP] 1 [/SUP], Yuya Kamura[SUP] 1 [/SUP], Daisuke Ikeda[SUP] 1 [/SUP], Ayumi Kuzume[SUP] 1 [/SUP], Rikako Tabata[SUP] 1 [/SUP], Takafumi Tsushima[SUP] 1 [/SUP], Daisuke Miura[SUP] 1 [/SUP], Kentaro Narita[SUP] 1 [/SUP], Masami Takeuchi[SUP] 1 [/SUP], Masahiro Doi[SUP] 4 [/SUP], Yuka Umezawa[SUP] 4 [/SUP], Yoshihito Otsuka[SUP] 4 [/SUP], Hiroyuki Takamatsu[SUP] #[/SUP][SUP] 5 [/SUP], Kosei Matsue[SUP] #[/SUP][SUP] 6 [/SUP]
Affiliations
- PMID: 35190963
- DOI: 10.1007/s12185-022-03300-4
Abstract
We conducted a prospective, three-center, observational study in Japan to evaluate the prevalence of seropositivity and clinically protective titer after coronavirus disease 2019 vaccination in patients with plasma cell dyscrasia(PCD). Two-hundred sixty-nine patients with PCD [206 symptomatic multiple myeloma (MM)] were evaluated. Seropositivity was observed in 88.7% and a clinically protective titer in 38.3% of MM patients, both of which were significantly lower than those of healthy controls. Patients receiving anti-CD38 antibodies had much lower antibody titers, but antibody titers recovered in those who underwent a wash-out period before vaccine administration. Older age (≥65), anti-CD38 antibody administration, immunomodulatory drugs use, lymphopenia (<1000/μL), and lower polyclonal IgG (<550 mg/dL) had a negative impact for the sufficient antibody production according to multivariate analysis. Patients with clinically protective titer had a significantly higher number of CD19+ lymphocytes than those with lower antibody responses (114 vs. 35/μL, p = 0.016). Our results suggested that patients with PCD should be vaccinated, and that the ideal protocol is to temporarily interrupt anti-CD38 antibody therapy for a "wash-out" period of a few months, followed by a (booster) vaccine after the B-cells have recovery.
Keywords: Anti-CD38 antibody; COVID-19; Multiple myeloma; Plasma cell dyscrasia; SARS-CoV-2; mRNA vaccine.