Published in:
12-12-2023 | COVID-19 Vaccination | Original Article
Negative impact of immunoparesis in response to anti-SARS-CoV-2 mRNA vaccination of patients with multiple myeloma
Authors:
Akio Onishi, Yayoi Matsumura-Kimoto, Shinsuke Mizutani, Reiko Isa, Takahiro Fujino, Taku Tsukamoto, Akihiro Miyashita, Keita Okumura, Daichi Nishiyama, Koichi Hirakawa, Kazuho Shimura, Hiroto Kaneko, Miki Kiyota, Eri Kawata, Ryoichi Takahashi, Tsutomu Kobayashi, Hitoji Uchiyama, Nobuhiko Uoshima, Yoko Nukui, Yuji Shimura, Tohru Inaba, Junya Kuroda, Kyoto Clinical Hematology Study Group investigators
Published in:
International Journal of Hematology
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Issue 1/2024
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Abstract
Multiple myeloma reduces cellular and humoral immunity. Optimal prediction of antibody response to anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in patients with MM and related disorders is essential to prevent coronavirus disease 2019 (COVID-19) during the SARS-CoV-2 pandemic. This study analyzed the humoral response to the anti-SARS-CoV-2 messenger ribonucleic acid (mRNA) vaccine and its associated factor in 83 patients from June to November 2021 at seven member institutions of the Kyoto Clinical Hematology Study Group. SARS-CoV-2 neutralizing antibody (nAb) was measured from 12 to 210 days. The result revealed that 40 (48.2%) patients with MM and 59 (100%) healthy controls became seropositive after vaccination. Receiver operating characteristic curve analysis identified serum immunoglobulin (Ig) M of > 18 mg/dL at vaccination as the optimal threshold level associated with seropositivity in the whole cohort. Moreover, the multivariate analysis identified serum IgM of > 18 mg/dL as the independent predictor for a favorable response. Serum IgA level was positively associated with vaccine response in a sub-cohort. Our findings indicate a significant association between immunoparesis and impaired humoral response against mRNA vaccination, including that against SARS-CoV-2, and that serum non-M-protein Ig levels can serve as surrogate biomarkers of nAb production ability.