Immune responses to COVID-19 booster vaccinations in intensively anti-CD38 antibody treated patients with ultra-high-risk multiple myeloma: results from the Myeloma UK (MUK) nine OPTIMUM trial

Multiple myeloma (MM) and anti-MM therapy cause profound immunosuppression, leaving patients vulnerable to coronavirus disease 2019 (COVID-19) and other infections. We investigated anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies longitudinally in ultra-high-risk patients with MM receiving risk-adapted, intensive anti-CD38 combined therapy in the Myeloma UK (MUK) nine trial. Despite continuous intensive therapy, seroconversion was achieved in all patients, but required a greater number of vaccinations compared to healthy individuals, highlighting the importance of booster vaccinations in this population. Reassuringly, high antibody cross-reactivity was found with current variants of concern, prior to Omicron subvariant adapted boostering. Multiple booster vaccine doses can provide effective protection from COVID-19, even with intensive anti-CD38 therapy for high-risk MM.

Automated summary

Patients with multiple myeloma and undergoing anti-myeloma therapy are at high risk of COVID-19 due to immunosuppression. A study on high-risk MM patients in the UK found that they required more vaccine doses to achieve seroconversion compared to healthy individuals, emphasizing the importance of booster vaccinations in this population. Reassuringly, high antibody cross-reactivity was observed with current variants of concern, indicating the effectiveness of multiple booster vaccine doses in providing COVID-19 protection for high-risk MM patients, even with intensive anti-CD38 therapy.