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.
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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