Augmentation of humoral and cellular immune responses after third-dose SARS-CoV-2 vaccination and viral neutralization in myeloma patients
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19
Despite the efficacy of COVID-19 vaccines in healthy individuals, multiple myeloma (MM) patients are immunocompromised and mount suboptimal humoral and cellular responses after two doses of mRNA vaccine (Addeo et al., 2021; Aleman et al., 2021; Van Oekelen et al., 2021). A broader observation of limited vaccine responses in cancer patients, particularly those with hematologic malignancies (Thakkar et al., 2021), has led to the implementation of additional (i.e., third-dose) vaccine administration as a way to increase protection for patients with immune suppression. A third dose of BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine has shown to be effective in preventing severe COVID-19 caused by the SARS-CoV-2 B.1.617.2 (Delta) variant in the general population (Bar-On et al., 2021; Barda et al., 2021). Furthermore, third-dose administration of either the BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) COVID-19 vaccine was associated with augmented immune responses in a diverse cohort of cancer patients (Shapiro et al., 2022). However, the real-world effectiveness of additional dosing in myeloma patients and viral neutralization have not been reported. Additionally, the impact of the currently dominant SARS-CoV-2 B.1.1.529 (Omicron) variant on efficacy of the third dose is largely unknown in patients with hematologic malignancies (Zeng et al., 2022).
We studied the humoral and cellular immune response to COVID-19 vaccination longitudinally in a real-world cohort of 476 MM patients and compared it with data of age-matched vaccinated healthcare workers. Of the full cohort, 354 patients (74%) had anti-SARS-CoV-2 spike (S) IgG levels collected at least 6 months after two doses of mRNA vaccine, and 261 (55%) had anti-S IgG measured at least 1 week after the third dose administration. Summarized demographic characteristics of the cohort are shown in Table S1. The study cohort was predominantly male (57%), with a median age of 67 years (range 38–96 years). Forty patients (8%) were included with a diagnosis of smoldering MM. Patients included had received a median of two lines of treatment (range 0–16) at the time of initial vaccination. Of note, documented COVID-19 infection occurred in 124 patients (26%) at any time during the pandemic.
Cancer Cell , éditorial en libre accès, 2021