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Low Spike Antibody Levels and Impaired BA.4/5 Neutralization in Patients with Multiple Myeloma or Waldenstrom's Macroglobulinemia after BNT162b2 Booster Vaccination

  1. Author:
    Rosati, Margherita
    Terpos, Evangelos [ORCID]
    Bear,Jenifer
    Burns,Robert
    Devasundaram,Santhi [ORCID]
    Ntanasis-Stathopoulos, Ioannis [ORCID]
    Gavriatopoulou, Maria
    Kastritis, Efstathios [ORCID]
    Dimopoulos, Meletios-Athanasios [ORCID]
    Pavlakis, George N [ORCID]
    Felber,Barbara

  2. Author Address

    Human Retrovirus Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute at Frederick, Frederick, MD 21702, USA., Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 117 27 Athens, Greece., Human Retrovirus Pathogenesis Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute at Frederick, Frederick, MD 21702, USA.,
    1. Year: 2022
    2. Date: Nov 25
    3. Epub Date: 2022 11 25
  2. Journal: Cancers
    1. 14
    2. 23
  4. Type of Article: Article
  5. Article Number: 5816
  1. Abstract:

    Patients with symptomatic monoclonal gammopathies have impaired humoral responses to COVID-19 vaccination. Their ability to recognize SARS-CoV-2 Omicron variants is of concern. We compared the response to BNT162b2 mRNA vaccinations of patients with multiple myeloma (MM, n = 60) or Waldenstrom 39;s macroglobulinemia (WM, n = 20) with healthy vaccine recipients (n = 37). Patient cohorts on active therapy affecting B cell development had impaired binding and neutralizing antibody (NAb) response rate and magnitude, including several patients lacking responses, even after a 3rd vaccine dose, whereas non-B cell depleting therapies had a lesser effect. In contrast, MM and WM cohorts off-therapy showed increased NAb with a broad response range. ELISA Spike-Receptor Binding Domain (RBD) Ab titers in healthy vaccine recipients and patient cohorts were good predictors of the ability to neutralize not only the original WA1 but also the most divergent Omicron variants BA.4/5. Compared to WA1, significantly lower NAb responses to BA.4/5 were found in all patient cohorts on-therapy. In contrast, the MM and WM cohorts off-therapy showed a higher probability to neutralize BA.4/5 after the 3rd vaccination. Overall, the boost in NAb after the 3rd dose suggests that repeat vaccination of MM and WM patients is beneficial even under active therapy.

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External Sources

  1. View Full Text
  2. DOI: 10.3390/cancers14235816
  3. PMID: 36497296
  4. PMCID: PMC9737406
  5. PII : cancers14235816

Library Notes

  1. Fiscal Year: FY2022-2023
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