Abstract
The humoral and cellular response to SARS-CoV-2 mRNA full vaccination and booster dose as well as the impact of the spike variants, including Omicron, are still unclear in patients with multiple myeloma (MM) and those with pre-malignant monoclonal gammopathies. In this study, involving 40 patients, we found that MM patients with relapsed-refractory disease (MMR) had reduced spike-specific antibody levels and neutralizing titers after SARS-CoV-2 vaccination. The five analyzed variants, remarkably Omicron, had a significant negative impact on the neutralizing ability of the vaccine-induced antibodies in all patients with MM and smoldering MM. Moreover, lower spike-specific IL-2-producing CD4 + T cells and reduced cytotoxic spike-specific IFN-γ and TNF-α-producing CD8 + T cells were found in MM patients as compared to patients with monoclonal gammopathy of undetermined significance. We found that a heterologous booster immunization improved SARS-CoV-2 spike humoral and cellular responses in newly diagnosed MM (MMD) patients and in most, but not all, MMR patients. After the booster dose, a significant increase of the neutralizing antibody titers against almost all the analyzed variants was achieved in MMD. However, in MMR patients, Omicron retained a negative impact on neutralizing ability, suggesting further approaches to potentiating the effectiveness of SARS-CoV-2 vaccination in these patients.
Keywords: Multiple myeloma; Omicron; SARS-CoV-2; monoclonal gammopathies; neutralizing antibodies; spike variants.
【저자키워드】 SARS-CoV-2, Neutralizing antibodies, omicron, Multiple myeloma, monoclonal gammopathies, spike variants., 【초록키워드】 vaccination, variant, CD4, CD8, immunization, variants, T cell, mRNA, Patient, Effectiveness, Neutralizing, spike variants, disease, booster dose, patients, Heterologous, booster, SARS-CoV-2 vaccination, IFN-γ, Neutralizing antibody titer, monoclonal, SARS-CoV-2 spike, Neutralizing titer, cellular response, MMR, humoral, significant increase, Multiple, Undetermined, Spike-specific antibody, FIVE, MMD, analyzed, approach, diagnosed, reduced, retained, vaccine-induced antibody, 【제목키워드】 mRNA vaccination, variant, Patient, booster dose, monoclonal, humoral,