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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

SIMPLE SUMMARY: Upon BNT162b2 mRNA vaccinations, multiple myeloma (MM) and Waldenstrom’s macroglobulinemia (WM) patient cohorts on active therapy affecting B cell development had impaired binding and neutralizing antibody (NAb) response rate and magnitude to wildtype Wuhan (WA1). Patient cohorts on-...

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Autores principales: Rosati, Margherita, Terpos, Evangelos, Bear, Jenifer, Burns, Robert, Devasundaram, Santhi, Ntanasis-Stathopoulos, Ioannis, Gavriatopoulou, Maria, Kastritis, Efstathios, Dimopoulos, Meletios-Athanasios, Pavlakis, George N., Felber, Barbara K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9737406/
https://www.ncbi.nlm.nih.gov/pubmed/36497296
http://dx.doi.org/10.3390/cancers14235816
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author Rosati, Margherita
Terpos, Evangelos
Bear, Jenifer
Burns, Robert
Devasundaram, Santhi
Ntanasis-Stathopoulos, Ioannis
Gavriatopoulou, Maria
Kastritis, Efstathios
Dimopoulos, Meletios-Athanasios
Pavlakis, George N.
Felber, Barbara K.
author_facet Rosati, Margherita
Terpos, Evangelos
Bear, Jenifer
Burns, Robert
Devasundaram, Santhi
Ntanasis-Stathopoulos, Ioannis
Gavriatopoulou, Maria
Kastritis, Efstathios
Dimopoulos, Meletios-Athanasios
Pavlakis, George N.
Felber, Barbara K.
author_sort Rosati, Margherita
collection PubMed
description SIMPLE SUMMARY: Upon BNT162b2 mRNA vaccinations, multiple myeloma (MM) and Waldenstrom’s macroglobulinemia (WM) patient cohorts on active therapy affecting B cell development had impaired binding and neutralizing antibody (NAb) response rate and magnitude to wildtype Wuhan (WA1). Patient cohorts on-therapy had significantly lower NAb responses to SARS-CoV-2 Omicron variant BA.4/5 compared to WA1, whereas cohorts off-therapy showed a higher probability to neutralize BA.4/5 after the 3rd vaccination. The boost in NAb after the 3rd dose suggests that repeat vaccination of MM and WM patients is beneficial for several patients even under active therapy. 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’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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spelling pubmed-97374062022-12-11 Low Spike Antibody Levels and Impaired BA.4/5 Neutralization in Patients with Multiple Myeloma or Waldenstrom’s Macroglobulinemia after BNT162b2 Booster Vaccination Rosati, Margherita Terpos, Evangelos Bear, Jenifer Burns, Robert Devasundaram, Santhi Ntanasis-Stathopoulos, Ioannis Gavriatopoulou, Maria Kastritis, Efstathios Dimopoulos, Meletios-Athanasios Pavlakis, George N. Felber, Barbara K. Cancers (Basel) Article SIMPLE SUMMARY: Upon BNT162b2 mRNA vaccinations, multiple myeloma (MM) and Waldenstrom’s macroglobulinemia (WM) patient cohorts on active therapy affecting B cell development had impaired binding and neutralizing antibody (NAb) response rate and magnitude to wildtype Wuhan (WA1). Patient cohorts on-therapy had significantly lower NAb responses to SARS-CoV-2 Omicron variant BA.4/5 compared to WA1, whereas cohorts off-therapy showed a higher probability to neutralize BA.4/5 after the 3rd vaccination. The boost in NAb after the 3rd dose suggests that repeat vaccination of MM and WM patients is beneficial for several patients even under active therapy. 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’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. MDPI 2022-11-25 /pmc/articles/PMC9737406/ /pubmed/36497296 http://dx.doi.org/10.3390/cancers14235816 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rosati, Margherita
Terpos, Evangelos
Bear, Jenifer
Burns, Robert
Devasundaram, Santhi
Ntanasis-Stathopoulos, Ioannis
Gavriatopoulou, Maria
Kastritis, Efstathios
Dimopoulos, Meletios-Athanasios
Pavlakis, George N.
Felber, Barbara K.
Low Spike Antibody Levels and Impaired BA.4/5 Neutralization in Patients with Multiple Myeloma or Waldenstrom’s Macroglobulinemia after BNT162b2 Booster Vaccination
title Low Spike Antibody Levels and Impaired BA.4/5 Neutralization in Patients with Multiple Myeloma or Waldenstrom’s Macroglobulinemia after BNT162b2 Booster Vaccination
title_full Low Spike Antibody Levels and Impaired BA.4/5 Neutralization in Patients with Multiple Myeloma or Waldenstrom’s Macroglobulinemia after BNT162b2 Booster Vaccination
title_fullStr Low Spike Antibody Levels and Impaired BA.4/5 Neutralization in Patients with Multiple Myeloma or Waldenstrom’s Macroglobulinemia after BNT162b2 Booster Vaccination
title_full_unstemmed Low Spike Antibody Levels and Impaired BA.4/5 Neutralization in Patients with Multiple Myeloma or Waldenstrom’s Macroglobulinemia after BNT162b2 Booster Vaccination
title_short Low Spike Antibody Levels and Impaired BA.4/5 Neutralization in Patients with Multiple Myeloma or Waldenstrom’s Macroglobulinemia after BNT162b2 Booster Vaccination
title_sort low spike antibody levels and impaired ba.4/5 neutralization in patients with multiple myeloma or waldenstrom’s macroglobulinemia after bnt162b2 booster vaccination
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9737406/
https://www.ncbi.nlm.nih.gov/pubmed/36497296
http://dx.doi.org/10.3390/cancers14235816
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