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Blood Adv . Immunogenicity of SARS-CoV-2 vaccines in patients with multiple myeloma: a systematic review and meta-analysis

tetano

Editor, Senior Moderator
Blood Adv


. 2022 Dec 27;6(24):6198-6207.
doi: 10.1182/bloodadvances.2022008530.
Immunogenicity of SARS-CoV-2 vaccines in patients with multiple myeloma: a systematic review and meta-analysis


Nipat Chuleerarux[SUP] 1 [/SUP], Kasama Manothummetha[SUP] 2 [/SUP], Chatphatai Moonla[SUP] 3 [/SUP], Anawin Sanguankeo[SUP] 4 [/SUP], Olivia S Kates[SUP] 5 [/SUP], Nattiya Hirankarn[SUP] 2 [/SUP], Kasidis Phongkhun[SUP] 3 [/SUP], Jaedvara Thanakitcharu[SUP] 6 [/SUP], Surachai Leksuwankun[SUP] 3 [/SUP], Tanaporn Meejun[SUP] 7 [/SUP], Achitpol Thongkam[SUP] 2 [/SUP], Thanuthong Mongkolkaew[SUP] 2 [/SUP], M Veronica Dioverti[SUP] 5 [/SUP], Pattama Torvorapanit[SUP] 3 [/SUP], Nattapong Langsiri[SUP] 2 [/SUP], Navaporn Worasilchai[SUP] 8 [/SUP], Rongpong Plongla[SUP] 3 [/SUP], Ariya Chindamporn[SUP] 2 [/SUP], Shilpa Gopinath[SUP] 5 [/SUP], Pitchaphon Nissaisorakarn[SUP] 9 [/SUP], Tany Thaniyavarn[SUP] 10 11 [/SUP], Saman Nematollahi[SUP] 12 [/SUP], Nitipong Permpalung[SUP] 2 5 [/SUP]



Affiliations

Abstract

Patients with multiple myeloma (MM) have a diminished immune response to coronavirus disease 2019 (COVID-19) vaccines. Risk factors for an impaired immune response are yet to be determined. We aimed to summarize the COVID-19 vaccine immunogenicity and to identify factors that influence the humoral immune response in patients with MM. Two reviewers independently conducted a literature search in MEDLINE, Embase, ISI Web of Science, Cochrane library, and Clinicaltrials.gov from existence until 24 May 24 2022. (PROSPERO: CRD42021277005). A total of 15 studies were included in the systematic review and 5 were included in the meta-analysis. The average rate (range) of positive functional T-lymphocyte response was 44.2% (34.2%-48.5%) after 2 doses of messenger RNA (mRNA) COVID-19 vaccines. The average antispike antibody response rates (range) were 42.7% (20.8%-88.5%) and 78.2% (55.8%-94.2%) after 1 and 2 doses of mRNA COVID-19 vaccines, respectively. The average neutralizing antibody response rates (range) were 25% (1 study) and 62.7% (53.3%-68.6%) after 1 and 2 doses of mRNA COVID-19 vaccines, respectively. Patients with high-risk cytogenetics or receiving anti-CD38 therapy were less likely to have a humoral immune response with pooled odds ratios of 0.36 (95% confidence interval [95% CI], 0.18, 0.69), I2 = 0% and 0.42 (95% CI, 0.22, 0.79), I2 = 14%, respectively. Patients who were not on active MM treatment were more likely to respond with pooled odds ratio of 2.42 (95% CI, 1.10, 5.33), I2 = 7%. Patients with MM had low rates of humoral and cellular immune responses to the mRNA COVID-19 vaccines. Further studies are needed to determine the optimal doses of vaccines and evaluate the use of monoclonal antibodies for pre-exposure prophylaxis in this population.
 
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