Third Dose of COVID-19 Vaccine Significantly Increases Immune Responses in Most Patients With Multiple Myeloma

A new study found that most immunocompromised patients with multiple myeloma benefited from a third dose of a COVID-19 vaccine; however, some of these patients remained vulnerable and may require a fourth dose or antibody treatments as new COVID-19 variants emerge, according to a study published in Cancer Cell conducted by researchers at Mount Sinai Hospital and the Mount Sinai School of Medicine.

“This study is the first to comprehensively capture the immune effect of the third dose of the COVID-19 vaccine in patients with plasma cell disorders and blood cancers like multiple myeloma,” one of the study’s lead authors, Samir Parekh, MD, director of Translational Research in Multiple Myeloma at The Tisch Cancer Institute at Mount Sinai and Professor of Medicine (Hematology and Medical Oncology), and Oncological Sciences, at the Icahn School of Medicine at Mount Sinai, said in a press release. “It provides guidance to myeloma patients, who are at risk for severe infection because they may be immunocompromised due to the disease itself and the cancer treatment.”

The investigators noted that in previous studies, breakthrough infections were observed in patients with multiple myeloma associated with poor or no response to the normal regimen of COVID-19 vaccines. The patients’ vulnerability statuses then led to antibody testing and a third vaccine to potentially increase the immune response.

The recent study collected blood samples from 476 patients with plasma cell disorders over a period of 15 months and were compared to samples collected from healthy, vaccinated health care workers. In the findings, a third dose produced a significant increase in the level of antibodies in patients with and without prior COVID-19 infection. However, the levels of COVID-19 fighting antibodies in patients with multiple myeloma remained below those observed in healthy people.

Approximately one-quarter of the patients with multiple myeloma had no detectable antibodies following the standard 2-dose vaccine series; however, in this group, 88% developed antibodies after a third dose. Additionally, the third dose also led to an increase of other immune cells, such as T cells and B cells, which also helps to neutralize COVID-19.

“Our findings underscore the need for continued monitoring of immune responses and further research around measures such as additional vaccine doses or passive immunization for individual multiple myeloma patients who may remain vulnerable after third-dose vaccination, especially as COVID-19 restrictions are being lifted worldwide and new waves of viral variants are emerging,” the study’s other lead author, Viviana A. Simon, MD, PhD, professor of Microbiology, Infectious Diseases, and Pathology, Molecular and Cell Based Medicine at the Icahn School of Medicine at Mount Sinai, said in a press release.

REFERENCE

Third dose of COVID-19 vaccine significantly increases immune responses in most patients with multiple myeloma. EurekAlert! April 6, 2022. Accessed April 7, 2022. https://www.eurekalert.org/news-releases/948958