COVID-19 and Myeloma: Antibody Responses Against SARS–CoV-2 in Elderly Patients
Posted: Tuesday, July 6, 2021
According to a letter published in Blood, elderly patients with multiple myeloma showed lower levels of neutralizing antibodies against SARS–CoV-2 after the first dose of BNT162b2 vaccine. A research team consisting of Evangelos Terpos, MD, of the National and Kapodistrian University of Athens, and colleagues assessed the effect of BNT162b2 vaccine on patients with multiple myeloma, a group at heightened risk of hospital admission and death from SARS–CoV-2 infection.
This study included 48 patients with multiple myeloma, mostly men (n = 29; 60%), with a median age of 83 (range, aged 59–92). Advanced participant age was due in part to Greek vaccination programs that prioritize vaccination among healthcare workers and those 80 years or older. Patients with multiple myeloma were included irrespective of treatment regimen and were matched for controls (n = 104) based on age and sex. These patients and controls were participants in a larger observational study of 600 individuals to explore the kinetics of antibodies against COVID-19 (ClinicalTrials.gov identifier NCT04743388). Serum samples were collected on days 1 and 22 after the first dose and assessed for neutralizing antibodies against SARV–CoV-2.
No participant tested positive for neutralizing antibodies on day 1 (≥ 30% cutoff); however, on day 22, patients with multiple myeloma had lower neutralizing antibody titers than did controls, with a median rate of 20.6% for patients with multiple myeloma versus 32.5% for controls (P < .01). Neutralizing antibody titers above 50%, corresponding to clinically relevant viral inhibition, was observed in 4 patients and 21 controls; interestingly, the 4 patients with multiple myeloma were all in remission without antimyeloma therapy. According to the investigators, antimyeloma therapy seemed to negatively affect the production of neutralizing antibodies against SARV–CoV-2; however, more research is needed to evaluate the effects of specific treatment regimens on the immune response to the vaccine.
Disclosure: The authors reported no conflicts of interest.