Patients with hematologic malignancies, such as multiple myeloma, have a higher risk of severe COVID-19 disease and have a reduced antibody response after vaccination against SARS-CoV-2. Relevant research from the Therapeutic Clinic of the National and Kapodistrian University of Athens, led by Professors Evangelos Terpo and Thanos Dimopoulos (Dean of the National and Kapodistrian University of Athens), has highlighted the reduced production of neutralizing antibodies against SARS-CoV-2 after COVID-19 vaccination in patients with symptomatic multiple myeloma compared to healthy subjects (Blood 2021, 137, 3674-3676 and Blood Cancer Journal 2021, 11, 138).
Recently accepted for publication in the prestigious scientific journal Blood (official journal of the American Society of Hematology) was the new study of the Therapeutic Clinic of EKPA on the efficacy of a third booster dose of BNT162b2 vaccine in patients with symptomatic multiple myeloma.
This study evaluated the development of neutralizing antibodies against SARS-CoV-2 one month after administration of the third dose of the BNT162b2b2 mRNA vaccine (Pfizer-BioNtech) in patients with multiple myeloma. The measurement was performed using a US FDA-approved methodology. According to this method, values below 30% indicate the absence of neutralising antibodies able to counteract the virus, while values above 50% indicate significant protection against the virus (measurements refer to the original coronavirus strain, i.e. that of Wuhan).
In total, 167 patients with a median age of 68 years were included; 58% were male. 93% of the patients were receiving anti-myeloma therapy at the time of vaccination. The 3rd dose of the vaccine significantly increased the antibody response against SARS-CoV-2. The median neutralizing antibody titer reached 96.7% one month after the third dose compared with 27.1% before the third dose.
Of note, 75 of 114 patients (66%), who had a neutralizing antibody titer below 50% before the 3rd dose, gained a titer of 50% or more after the 3rd dose. In addition, 32 of 57 patients (56%) who had not developed neutralizing antibodies after the first two doses of the vaccine gained an antibody titer of more than 30% after the 3rd dose. In multivariate analysis, it appeared that treatment with anti-myeloma agents was associated with a reduced antibody response after the 3rd dose of BNT162b2. In conclusion, this study demonstrates the importance of administering a booster dose of SARS-CoV-2 vaccine in patients with multiple myeloma. This is true even for patients with an unsatisfactory antibody response after the first two vaccinations, as the 3rd dose promotes the antibody response in more than half of them.
The study involved Professor Evangelos Terpos, Associate Professor Maria Gavriatopoulou, Dr. Ioannis Danasis-Stathopoulos, Assistant Professor Alexandros Briassoulis, Dr. Panagiotis Malandrakis, Dr. Magdalene Migou, Dr. Nikolaos Kanelias, Professor Efstathios Kastritis and Professor and Rector Thanos Dimopoulos from the Therapeutic Clinic of the Medical School of the University of Athens, as well as Professor Ioannis Trougakos, biologist Cediliana Goumeni and biologist Eleni-Demitra Papanagou from the Department of Biology of the University of Athens.
Source: CNA
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