Reference Database

Multiple myeloma (MM) is considered a high-priority condition for vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The immune response to the vaccine is uncertain. Because high titers of neutralizing antibodies (nAbs) are necessary to inhibit the delta variant of the virus, patients with impaired immune response may be at risk of breakthrough infection. We prospectively investigated the humoral and cellular immunologic response to anti–SARS-CoV-2 messenger RNA (mRNA) vaccine (Pfizer-BioNTech BNT162b2) in patients with MM who were receiving therapy or in whom treatment was discontinued within 12 months (from January 2021) at a single tertiary care institution in Paris.
In agreement with recent reports, we observed heterogeneous humoral response to vaccine in patients with MM who had never been infected with SARS-CoV-2. Patients with MM who were treated with anti-CD38 immunotherapy remain at higher risk of SARS-CoV-2 infection after mRNA-based vaccination compared with patients who receive alternative therapies. In contrast, patients with MM who became infected with SARS-CoV-2 before and after vaccination had homogeneous and robust immune response. Our preliminary results on booster vaccination also suggest that immune response to SARS-CoV-2 remains actionable in patients with MM. Improvement of vaccine formulation such as adjuvant use or heterologous vaccination procedure should be considered in this frail population.