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Immune response to COVID-19 vaccination is attenuated by poor disease control and antimyeloma therapy with vaccine driven divergent T cell response

Abstract:
Myeloma patients frequently respond poorly to bacterial and viral vaccination. A few studies have reported poor humoral immune responses in myeloma patients to COVID-19 vaccination. Using a prospective study of myeloma patients in the UK Rudy study cohort, we assessed humoral and interferon gamma release assay (IGRA) cellular immune responses to COVID-19 vaccination post second COVID-19 vaccine administration. We report data from 214 adults with myeloma (n = 204) or smouldering myeloma (n = 10) who provided blood samples at least three weeks after second vaccine dose. Positive Anti-spike antibody levels (> 50 iu/ml) were detected in 189/203 (92.7%), positive IGRA responses were seen in 97/158 (61.4%) myeloma patients. Only 10/158 (6.3%) patients were identified to have both a negative IGRA and negative anti-spike protein antibody response. In all, 95/158 (60.1%) patients produced positive results for both anti-spike protein serology and IGRA. After adjusting for disease severity and myeloma therapy, poor humoral immune response was predicted by male gender. Predictors of poor IGRA included anti-CD38/anti-BCMA (B-cell maturation antigen) therapy and Pfizer-BioNTech vaccination. Further work is required to understand the clinical significance of divergent cellular response to vaccination.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1111/bjh.18066

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Rothermere American Institute
Role:
Author
ORCID:
0000-0003-3385-3707


Publisher:
Wiley
Journal:
British Journal of Haematology More from this journal
Volume:
197
Issue:
3
Pages:
293-301
Publication date:
2022-02-17
Acceptance date:
2022-01-15
DOI:
EISSN:
1365-2141
ISSN:
0007-1048
Pmid:
35064676


Language:
English
Keywords:
Pubs id:
1235879
Local pid:
pubs:1235879
Deposit date:
2022-05-22

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