Ghandili Susanne, Schönlein Martin, Lütgehetmann Marc, Schulze Zur Wiesch Julian, Becher Heiko, Bokemeyer Carsten, Sinn Marianne, Weisel Katja C, Leypoldt Lisa B
University Cancer Center Hamburg, Department of Oncology, Hematology and Bone Marrow Transplantation, Section of Pneumology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
The Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
Cancers (Basel). 2021 Jul 28;13(15):3800. doi: 10.3390/cancers13153800.
Few data are available regarding the efficacy of anti-SARS-CoV-2 vaccines in patients with hematological malignancies, and particular, plasma cell neoplasia. This ongoing single-center study aimed to describe the level of post-vaccination anti-SARS-CoV-2-antibodies depending on B lymphocyte count, current therapy, and remission status of patients with multiple myeloma and related plasma cell dyscrasia, after the first dose of anti-SARS-CoV-2 vaccination. The 82 patients included in this study received SARS-CoV-2 vaccines (including mRNA- and vector-based vaccines) as a routine measure. After the first vaccination, a positive SARS-CoV-2 spike protein antibody titer (SP-AbT) was detected in 23% of assessable patients. SARS-CoV-2 SP-AbT was significantly higher in patients with higher CD19+ B lymphocyte counts. A cut-off value of ≥30 CD19+ B cells/µL was significantly positive correlating with higher SARS-CoV-2 SP-AbT. In contrast, current treatment with anti-CD38-antibodies has led to significantly reduced SP-AbT titers. Furthermore, in multivariable linear regression, higher age and insufficiently controlled disease significantly correlated negatively with SARS-CoV-2 SP-AbT. Conversely, treatment with immunomodulatory drugs did not harm the development of antibody titers. Based on our results, the majority of myeloma patients respond poorly after receiving the first dose of any anti-SARS-CoV-2 vaccination and need booster vaccination.
关于抗SARS-CoV-2疫苗在血液系统恶性肿瘤患者，尤其是浆细胞肿瘤患者中的疗效，可用数据较少。这项正在进行的单中心研究旨在描述在首次接种抗SARS-CoV-2疫苗后，多发性骨髓瘤及相关浆细胞异常增生患者的接种后抗SARS-CoV-2抗体水平，该水平取决于B淋巴细胞计数、当前治疗及缓解状态。本研究纳入的82例患者接受了SARS-CoV-2疫苗（包括基于mRNA和载体的疫苗）作为常规措施。首次接种后，在23%的可评估患者中检测到SARS-CoV-2刺突蛋白抗体滴度（SP-AbT）呈阳性。CD19+B淋巴细胞计数较高的患者中，SARS-CoV-2 SP-AbT显著更高。≥30个CD19+B细胞/µL的临界值与较高的SARS-CoV-2 SP-AbT显著正相关。相反，目前使用抗CD38抗体治疗导致SP-AbT滴度显著降低。此外，在多变量线性回归中，年龄较大和疾病控制不佳与SARS-CoV-2 SP-AbT显著负相关。相反，使用免疫调节药物治疗对抗体滴度的产生没有不良影响。根据我们的结果，大多数骨髓瘤患者在接种第一剂任何抗SARS-CoV-2疫苗后反应不佳，需要加强接种。
