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Anti-bacterial antibodies in multiple myeloma patients at disease presentation, in response to therapy and in remission: implications for patient management

Multiple myeloma (MM) is associated with increased risk of infection, but little is known regarding antibody levels against specific bacteria. We assessed levels of polyclonal immunoglobulin and antibacterial antibodies in patients recruited to the TEAMM trial, a randomised trial of antibiotic proph...

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Autores principales: Chicca, Ilaria J., Heaney, Jennifer L. J., Iqbal, Gulnaz, Dunn, Janet A., Bowcock, Stella, Pratt, Guy, Yong, Kwee L., Planche, Timothy D., Richter, Alex, Drayson, Mark T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7642409/
https://www.ncbi.nlm.nih.gov/pubmed/33149136
http://dx.doi.org/10.1038/s41408-020-00370-7
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author Chicca, Ilaria J.
Heaney, Jennifer L. J.
Iqbal, Gulnaz
Dunn, Janet A.
Bowcock, Stella
Pratt, Guy
Yong, Kwee L.
Planche, Timothy D.
Richter, Alex
Drayson, Mark T.
author_facet Chicca, Ilaria J.
Heaney, Jennifer L. J.
Iqbal, Gulnaz
Dunn, Janet A.
Bowcock, Stella
Pratt, Guy
Yong, Kwee L.
Planche, Timothy D.
Richter, Alex
Drayson, Mark T.
author_sort Chicca, Ilaria J.
collection PubMed
description Multiple myeloma (MM) is associated with increased risk of infection, but little is known regarding antibody levels against specific bacteria. We assessed levels of polyclonal immunoglobulin and antibacterial antibodies in patients recruited to the TEAMM trial, a randomised trial of antibiotic prophylaxis at the start of anti-myeloma treatment. Polyclonal IgG, IgA and IgM levels were below the reference range in 71%, 83% and 90% of 838 MM patients at diagnosis. Anti-vaccine targeted tetanus toxoid antibodies were protective in 95% of 193 healthy controls but only 41% of myeloma patients. In healthy controls, protective antibodies against 6/12 pneumococcal serotypes, haemophilus and meningococcus A were present in 67%, 41% and 56% compared to just 15%, 21% and 17% of myeloma patients. By 1 year, myeloma patients IgG levels had recovered for 57% of patients whilst the proportion with protective levels of IgG against thymus-dependent protein antigen tetanus toxoid had changed little. In contrast the proportions of patients with protective levels against thymus independent polysaccharide antigens pneumococcus, haemophilus and meningococcus had fallen from 15 to 7%, 21 to 0% and 17 to 11%. Findings highlight the need for strategies to protect patients against bacterial infections during therapy and vaccination programmes during remission.
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spelling pubmed-76424092020-11-10 Anti-bacterial antibodies in multiple myeloma patients at disease presentation, in response to therapy and in remission: implications for patient management Chicca, Ilaria J. Heaney, Jennifer L. J. Iqbal, Gulnaz Dunn, Janet A. Bowcock, Stella Pratt, Guy Yong, Kwee L. Planche, Timothy D. Richter, Alex Drayson, Mark T. Blood Cancer J Article Multiple myeloma (MM) is associated with increased risk of infection, but little is known regarding antibody levels against specific bacteria. We assessed levels of polyclonal immunoglobulin and antibacterial antibodies in patients recruited to the TEAMM trial, a randomised trial of antibiotic prophylaxis at the start of anti-myeloma treatment. Polyclonal IgG, IgA and IgM levels were below the reference range in 71%, 83% and 90% of 838 MM patients at diagnosis. Anti-vaccine targeted tetanus toxoid antibodies were protective in 95% of 193 healthy controls but only 41% of myeloma patients. In healthy controls, protective antibodies against 6/12 pneumococcal serotypes, haemophilus and meningococcus A were present in 67%, 41% and 56% compared to just 15%, 21% and 17% of myeloma patients. By 1 year, myeloma patients IgG levels had recovered for 57% of patients whilst the proportion with protective levels of IgG against thymus-dependent protein antigen tetanus toxoid had changed little. In contrast the proportions of patients with protective levels against thymus independent polysaccharide antigens pneumococcus, haemophilus and meningococcus had fallen from 15 to 7%, 21 to 0% and 17 to 11%. Findings highlight the need for strategies to protect patients against bacterial infections during therapy and vaccination programmes during remission. Nature Publishing Group UK 2020-11-04 /pmc/articles/PMC7642409/ /pubmed/33149136 http://dx.doi.org/10.1038/s41408-020-00370-7 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Chicca, Ilaria J.
Heaney, Jennifer L. J.
Iqbal, Gulnaz
Dunn, Janet A.
Bowcock, Stella
Pratt, Guy
Yong, Kwee L.
Planche, Timothy D.
Richter, Alex
Drayson, Mark T.
Anti-bacterial antibodies in multiple myeloma patients at disease presentation, in response to therapy and in remission: implications for patient management
title Anti-bacterial antibodies in multiple myeloma patients at disease presentation, in response to therapy and in remission: implications for patient management
title_full Anti-bacterial antibodies in multiple myeloma patients at disease presentation, in response to therapy and in remission: implications for patient management
title_fullStr Anti-bacterial antibodies in multiple myeloma patients at disease presentation, in response to therapy and in remission: implications for patient management
title_full_unstemmed Anti-bacterial antibodies in multiple myeloma patients at disease presentation, in response to therapy and in remission: implications for patient management
title_short Anti-bacterial antibodies in multiple myeloma patients at disease presentation, in response to therapy and in remission: implications for patient management
title_sort anti-bacterial antibodies in multiple myeloma patients at disease presentation, in response to therapy and in remission: implications for patient management
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7642409/
https://www.ncbi.nlm.nih.gov/pubmed/33149136
http://dx.doi.org/10.1038/s41408-020-00370-7
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