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Is the COVID-19 mRNA Vaccine Effective in Patients With Multiple Myeloma?

By: Kayci Reyer
Posted: Friday, October 15, 2021

According to research presented in Leukemia, patients with multiple myeloma who receive mRNA vaccination against COVID-19 may experience an impaired response. James R. Berenson, MD, of the Institute for Myeloma and Bone Cancer Research in California, and colleagues used an antispike IgG, enzyme-linked immunosorbent assay–based assay to detect antibody responses to the SARS–CoV-2 spike protein generated by mRNA-based vaccines.

The observational, single-clinic trial included 103 patients with multiple myeloma and 31 healthy subjects. Among patients with multiple myeloma, 96 had active disease, and 7 had smoldering disease. All participants completed a two-dose regimen of either the mRNA-1273 (Moderna) or BNT162b2 (Pfizer-BioNTech) vaccine. Serum antibody levels were measured three times: before vaccination, 12 to 21 days following the first dose of the vaccine, and 14 to 21 days following the second dose of the vaccine.

Patients were categorized by clinical response according to spike antibody levels, including clinically relevant response (> 250 IU/mL), partial response (50–250 IU/mL, above pre–COVID-19 background), and no response (< 50 IU/mL). Patients with smoldering disease had a superior response versus those with active disease. A total of 45% of patients with active myeloma achieved clinically significant responses (> 145 IU/mL), and 22% had a partial response. Higher antispike antibody levels were noted in patients who received mRNA-1273 versus those who received BNT162b2. Associations were observed between lower spike antibody levels and increased age, renal function impairments, two or more lines of treatment, and disease not in remission.

“Based on these data, myeloma patients may need to continue social distancing following COVID-19 vaccination, and postvaccine spike IgG levels may help guide decisions regarding future revaccination strategies and/or antibody prophylaxis for this vulnerable population,” concluded the authors.

Disclosure: The study authors reported no conflicts of interest.

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