Abstract
We conducted a prospective, three-center, observational study in Japan to evaluate the prevalence of seropositivity and clinically protective titer after coronavirus disease 2019 vaccination in patients with plasma cell dyscrasia(PCD). Two-hundred sixty-nine patients with PCD [206 symptomatic multiple myeloma (MM)] were evaluated. Seropositivity was observed in 88.7% and a clinically protective titer in 38.3% of MM patients, both of which were significantly lower than those of healthy controls. Patients receiving anti-CD38 antibodies had much lower antibody titers, but antibody titers recovered in those who underwent a wash-out period before vaccine administration. Older age (≥65), anti-CD38 antibody administration, immunomodulatory drugs use, lymphopenia (<1000/μL), and lower polyclonal IgG (<550 mg/dL) had a negative impact for the sufficient antibody production according to multivariate analysis. Patients with clinically protective titer had a significantly higher number of CD19+ lymphocytes than those with lower antibody responses (114 vs. 35/μL, p = 0.016). Our results suggested that patients with PCD should be vaccinated, and that the ideal protocol is to temporarily interrupt anti-CD38 antibody therapy for a “wash-out” period of a few months, followed by a (booster) vaccine after the B-cells have recovery.
Keywords: Anti-CD38 antibody; COVID-19; Multiple myeloma; Plasma cell dyscrasia; SARS-CoV-2; mRNA vaccine.
【저자키워드】 COVID-19, SARS-CoV-2, mRNA vaccine., Multiple myeloma, Plasma cell dyscrasia, Anti-CD38 antibody, 【초록키워드】 coronavirus disease, IgG, Vaccine, vaccination, therapy, protocol, antibody, mRNA vaccine, Antibody Response, lymphopenia, Prevalence, lymphocyte, symptomatic, Patient, Antibody titer, Seropositivity, Japan, plasma, age, patients, Plasma cell, Antibody titers, booster, Protective, B-cell, administration, Analysis, antibody production, healthy controls, anti-CD38, CD19+, Multiple, significantly lower, vaccine administration, Cell, polyclonal, evaluate, clinically, evaluated, conducted, receiving, suggested, significantly higher, much lower, immunomodulatory drug, 【제목키워드】 COVID-19 vaccine, mRNA, Patient, Protective,