Patients with Multiple Myeloma Mount Neutered Humoral Immune Response After COVID-19 Vaccination

A recent study has discovered that patients with multiple myeloma mount a neutered humoral immune response after vaccination of the coronavirus disease 2019 or COVID-19, especially when receiving antibody therapy.

Patients with Multiple Myeloma Mount Neutered Humoral Immune Response After COVID-19 Vaccination
Photo: Multiple Myeloma | InStyleHealth

What Is Multiple Myeloma?

Multiple myeloma is also known as “Kahler’s disease,” is a type of blood cancer. Normal plasma cells are found in the bone marrow and are an important part of the immune system.

A type of white blood cell called a “plasma cell” produces antibodies that fight infections and other diseases. Lymphocytes or lymph cells are one of the main types of white blood cells (WBC) in the immune system and include T cells and B cells. The lymphocytes can be found in different areas of the human body, including lymph nodes, the bone marrow, intestines, and bloodstream.

When a person has multiple myeloma, these plasma cells will reproduce the wrong way. These will let too much protein called “immunoglobulin” into the bones and blood. It will build up throughout the body and eventually will affect the organs.

These plasma cells will crowd out and overwhelm the regular blood cells in the bones. These will also secrete chemicals that will trigger other cells to eat away at human bones. The weak areas that these create in the bones are known as lytic lesions.

Experts registered 276 patients with a median age of 74 years, where 54.7% are men with plasma cell neoplasms, of whom 213 were diagnosed with multiple myeloma, 38 with smoldering myeloma or SMM, and 25 with monoclonal gammopathy of undetermined significance or MGUS. Parallel group of 226 healthy controls was also involved. All of the participants had been vaccinated with either both doses of the BNT162b2 shot or one dose of the AZD1222 vaccine.

Patients with malignancies showed significantly lower median levels of neutralizing antibody (Nab), 22 days after the first vaccine dose, inhibition titers than controls (27% vs 38.7%).

Furthermore, 42.4% of the patients tested positive for the presence of Nabs, defined as titers >30 %, significantly lower than the 64.2% positivity rate in controls. Nab titers >50% was defined as the threshold for clinically relevant viral inhibition and was attained by 19.9% and 32.3% of the respective participant subgroups.

The trend of weaker Nab responses in patients vs controls remained significant up to 4 weeks following the 2nd dose of the BNT162b62 vaccine or 7 weeks following the AZD1222 shot.

Also, patients on belantamab mafodotin or anti-CD38 monoclonal antibody therapy revealed a significantly lower day-50 median Nab titer relative to those on other treatment regimens (31.9% vs 62.8%).

 

Source: Blood Cancer J 2021;11:138

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