Second Booster BNT162b2 Restores SARS‐CoV‐2 Humoral Response in Patients With Multiple Myeloma, Excluding Those Under Anti‐BCMA Therapy

• Published in: HemaSphere 2022-08, Vol.6 (8), p.e764-n/a
• Main Authors: Ntanasis‐Stathopoulos, Ioannis, Karalis, Vangelis, Gavriatopoulou, Maria, Malandrakis, Panagiotis, Sklirou, Aimilia D., Eleutherakis‐Papaiakovou, Evangelos, Migkou, Magdalini, Roussou, Maria, Fotiou, Despina, Alexopoulos, Harry, Theodorakakou, Foteini, Kastritis, Efstathios, Iconomidou, Vassiliki A., Trougakos, Ioannis P., Dimopoulos, Meletios A., Terpos, Evangelos
• Format: Article
• Language: English
• ISSN: 2572-9241; 2572-9241
• DOI: 10.1097/HS9.0000000000000764

COVID‐19 vaccination leads to a less intense humoral response in patients with multiple myeloma (MM) compared with healthy individuals, whereas the SARS‐CoV‐2‐specific immunity fades over time. The purpose of this study was to explore the kinetics of SARS‐CoV‐2 neutralizing antibodies (NAbs) in patients with MM after vaccination with the BNT162b2 mRNA vaccine, focusing on their response before (B4D) and at 1 month after the fourth vaccination (M1P4D). Overall, 201 patients with a median age of 67 years were included, whereas 114 (56.7%) were men. The median NAbs levels B4D were 80.0% (±3.5%) and at M1P4D they increased to a median value of 96.1% (±3.7%). The NAb values at M1P4D were similar to those at 1 month post the third dose and superior to all previous timepoints. At M1P4D, the NAbs levels of all the treatment groups increased, apart from the anti‐BCMA group. A significant increase in median NAbs values was observed for those receiving CD38‐based treatment (n = 43, from 71.0% B4D to 96.0% at M1P4D) and those who did not receive CD38‐ or BCMA‐targeted therapy (n = 137, from 89.6% B4D to 96.3% at M1P4D). Regarding the patients under BCMA‐based therapy (n = 21), there was no remarkable increase in NAbs values following the second booster shot (from 3.0% B4D to 4.0% at M1P4D). In conclusion, booster vaccination with the BNT162b2 results in a substantially improved humoral response against SARS‐CoV‐2 in patients with MM. Anti‐BCMA treatment remains an adverse predictive factor for NAbs response; thus, tailored prevention measures should be considered for this patient subgroup.