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 - Funding Information:
Conflict-of-interest disclosure: S.N. reported receiving a grant from the Fisher Center Discovery Program, Johns Hopkins University. N.W., R.P., and A.C. reported receiving grants from the Health Systems Research Institute (Thailand) and Rachadapi-seksompotch Fund, Chulalongkorn University outside the
Funding Information:
The authors would like to extend our gratitude to librarians at Chulalongkorn University and Johns Hopkins University School of Medicine for their contribution of retrieving full papers of studies that were not available on the databases. No funding to be disclosed for the study.
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 -