Clinical Immunology Service, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
Br J Haematol. 2023 Jun;201(5):845-850. doi: 10.1111/bjh.18714. Epub 2023 Mar 9.
Multiple myeloma (MM) and anti-MM therapy cause profound immunosuppression, leaving patients vulnerable to coronavirus disease 2019 (COVID-19) and other infections. We investigated anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies longitudinally in ultra-high-risk patients with MM receiving risk-adapted, intensive anti-CD38 combined therapy in the Myeloma UK (MUK) nine trial. Despite continuous intensive therapy, seroconversion was achieved in all patients, but required a greater number of vaccinations compared to healthy individuals, highlighting the importance of booster vaccinations in this population. Reassuringly, high antibody cross-reactivity was found with current variants of concern, prior to Omicron subvariant adapted boostering. Multiple booster vaccine doses can provide effective protection from COVID-19, even with intensive anti-CD38 therapy for high-risk MM.
多发性骨髓瘤（MM）和抗 MM 治疗会导致严重的免疫抑制，使患者容易感染 2019 年冠状病毒病（COVID-19）和其他感染。我们在英国骨髓瘤（MUK）九项试验中，对接受风险适应性强化抗 CD38 联合治疗的超高危 MM 患者进行了抗严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）抗体的纵向研究。尽管持续进行强化治疗，但所有患者均实现了血清转化，但与健康个体相比，需要更多的疫苗接种，这突出表明在该人群中加强疫苗接种的重要性。令人欣慰的是，在奥密克戎亚变体适应强化之前，发现针对当前关注的变体具有高抗体交叉反应性。对于高危 MM，多次加强疫苗接种可以提供有效的 COVID-19 保护，即使进行了强化抗 CD38 治疗。
