期刊
ONCOIMMUNOLOGY
卷 11, 期 1, 页码 -出版社
TAYLOR & FRANCIS INC
DOI: 10.1080/2162402X.2022.2120275
关键词
Multiple myeloma; monoclonal gammopathies; SARS-CoV-2; spike variants; neutralizing antibodies; Omicron
资金
- Associazione Italiana per la Ricerca sul Cancro (AIRC) [20299]
- International Myeloma Society (IMS)
- Associazione Italiana contro Leucemie, Linfomi e Mielomi ONLUS, ParmAIL
The humoral and cellular response to SARS-CoV-2 vaccination is reduced in patients with multiple myeloma. Spike variants, especially Omicron, have a significant negative impact on the neutralizing ability of vaccine-induced antibodies. Heterologous booster immunization improves the response in newly diagnosed MM patients, but Omicron still poses challenges for patients with relapsed-refractory disease.
The humoral and cellular response to SARS-CoV-2 mRNA full vaccination and booster dose as well as the impact of the spike variants, including Omicron, are still unclear in patients with multiple myeloma (MM) and those with pre-malignant monoclonal gammopathies. In this study, involving 40 patients, we found that MM patients with relapsed-refractory disease (MMR) had reduced spike-specific antibody levels and neutralizing titers after SARS-CoV-2 vaccination. The five analyzed variants, remarkably Omicron, had a significant negative impact on the neutralizing ability of the vaccine-induced antibodies in all patients with MM and smoldering MM. Moreover, lower spike-specific IL-2-producing CD4(+) T cells and reduced cytotoxic spike-specific IFN-gamma and TNF-alpha-producing CD8(+) T cells were found in MM patients as compared to patients with monoclonal gammopathy of undetermined significance. We found that a heterologous booster immunization improved SARS-CoV-2 spike humoral and cellular responses in newly diagnosed MM (MMD) patients and in most, but not all, MMR patients. After the booster dose, a significant increase of the neutralizing antibody titers against almost all the analyzed variants was achieved in MMD. However, in MMR patients, Omicron retained a negative impact on neutralizing ability, suggesting further approaches to potentiating the effectiveness of SARS-CoV-2 vaccination in these patients.
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