Low clinical protective response to SARS-CoV-2 mRNA COVID-19 vaccine in patients with multiple myeloma

Toshiki Terao, Takeshi Yamashita, Ami Fukumoto, Yuya Kamura, Daisuke Ikeda, Ayumi Kuzume, Rikako Tabata, Takafumi Tsushima, Daisuke Miura, Kentaro Narita, Masami Takeuchi, Masahiro Doi, Yuka Umezawa, Yoshihito Otsuka, Hiroyuki Takamatsu, Kosei Matsue

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

We conducted a prospective, three-center, observational study in Japan to evaluate the prevalence of seropositivity and clinically protective titer after coronavirus disease 2019 vaccination in patients with plasma cell dyscrasia(PCD). Two-hundred sixty-nine patients with PCD [206 symptomatic multiple myeloma (MM)] were evaluated. Seropositivity was observed in 88.7% and a clinically protective titer in 38.3% of MM patients, both of which were significantly lower than those of healthy controls. Patients receiving anti-CD38 antibodies had much lower antibody titers, but antibody titers recovered in those who underwent a wash-out period before vaccine administration. Older age (≥65), anti-CD38 antibody administration, immunomodulatory drugs use, lymphopenia (<1000/μL), and lower polyclonal IgG (<550 mg/dL) had a negative impact for the sufficient antibody production according to multivariate analysis. Patients with clinically protective titer had a significantly higher number of CD19+ lymphocytes than those with lower antibody responses (114 vs. 35/μL, p = 0.016). Our results suggested that patients with PCD should be vaccinated, and that the ideal protocol is to temporarily interrupt anti-CD38 antibody therapy for a “wash-out” period of a few months, followed by a (booster) vaccine after the B-cells have recovery.

Original languageEnglish
Pages (from-to)737-747
Number of pages11
JournalInternational journal of hematology
Volume115
Issue number5
DOIs
Publication statusPublished - May 2022
Externally publishedYes

Keywords

  • Anti-CD38 antibody
  • COVID-19
  • mRNA vaccine
  • Multiple myeloma
  • Plasma cell dyscrasia
  • SARS-CoV-2

ASJC Scopus subject areas

  • Hematology

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