TY - JOUR
T1 - Immunogenicity of SARS-CoV-2 vaccines in patients with multiple myeloma
T2 - a systematic review and meta-analysis
AU - Chuleerarux, Nipat
AU - Manothummetha, Kasama
AU - Moonla, Chatphatai
AU - Sanguankeo, Anawin
AU - Kates, Olivia S.
AU - Hirankarn, Nattiya
AU - Phongkhun, Kasidis
AU - Thanakitcharu, Jaedvara
AU - Leksuwankun, Surachai
AU - Meejun, Tanaporn
AU - Thongkam, Achitpol
AU - Mongkolkaew, Thanuthong
AU - Dioverti, M. Veronica
AU - Torvorapanit, Pattama
AU - Langsiri, Nattapong
AU - Worasilchai, Navaporn
AU - Plongla, Rongpong
AU - Chindamporn, Ariya
AU - Gopinath, Shilpa
AU - Nissaisorakarn, Pitchaphon
AU - Thaniyavarn, Tany
AU - Nematollahi, Saman
AU - Permpalung, Nitipong
N1 - Publisher Copyright:
© 2022 by The American Society of Hematology.
PY - 2022/12/27
Y1 - 2022/12/27
N2 - 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.
AB - 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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U2 - 10.1182/bloodadvances.2022008530
DO - 10.1182/bloodadvances.2022008530
M3 - Review article
C2 - 36538342
AN - SCOPUS:85147587083
SN - 2473-9529
VL - 6
SP - 6198
EP - 6207
JO - Blood Advances
JF - Blood Advances
IS - 24
ER -