COVID-19 Vaccine Responses Among Patients With Multiple Myeloma
Posted: Friday, August 20, 2021
Patients with multiple myeloma mount a highly variable antibody response to vaccinations against COVID-19, and a large proportion (estimated 15.8%) do not appear to mount any antibody response. Samir Parekh, MBBS, of the Icahn School of Medicine at Mount Sinai in New York, published these findings along with colleagues in Cancer Cell.
Researchers tested the SARS–CoV-2 spike-binding IgG antibody levels in 320 patients with multiple myeloma who had received vaccinations in early 2021. Most patients (69.1%) received a dose of the Pfizer-BioNTech vaccine, 27.2% received the Moderna vaccine, and 3.8% of vaccinations were unknown. In addition, 18.8% of these patients had a documented COVID-19 infection prior to vaccination.
SARS–CoV-2 spike-binding IgG levels were measured at least 10 days after receiving the second vaccination dose in 81.3% of patients. Among these fully immunized patients, 84.2% mounted a detectable level of SARS–CoV-2 spike-binding IgG antibodies. The median level was 149 AU/mL; however, values ranged from 5 to 7,882 AU/mL. The remaining 15.8% of patients had antibody levels below the level of detection. In comparison, a control group of 67 health-care workers who were immunized had more homogeneous antibody levels, and all had detectable antibodies.
Patients receiving active therapy for myeloma had lower levels of SARS–CoV-2 spike-binding IgG antibodies compared with patients not receiving active therapy (70 AU/mL vs. 183 AU/mL, P = 0.004). Patients who did not mount an antibody response to vaccination were more likely to have the following factors: more previous lines of treatment (> 3 lines, P = .035), current active myeloma treatment (P = .005), grade 3 lymphopenia at the time of vaccination (P = .018), and receipt of anti-CD38 monoclonal antibody therapy or B-cell maturation antigen–targeted therapy (P = .042 or < .001, respectively).
Disclosure: For a full list of authors’ disclosures, visit cell.com.