Humoral response rate and predictors of response to BNT162b2 mRNA COVID19 vaccine in patients with multiple myeloma

Irit Avivi; Roi Balaban; Tamir Shragai; Gabi Sheffer; Miguel Morales; Anat Aharon; Noa Lowenton-Spier; Svetlana Trestman; Chava Perry; Noam Benyamini; Moshe Mittelman; Yaara Tabib; Tali Bar Lev; Mor Zavaro; Yair Herishanu; Efrat Luttwak; Yael C. Cohen

doi:10.1111/bjh.17608

Humoral response rate and predictors of response to BNT162b2 mRNA COVID19 vaccine in patients with multiple myeloma

Irit Avivi, Roi Balaban, Tamir Shragai, Gabi Sheffer, Miguel Morales, Anat Aharon, Noa Lowenton-Spier, Svetlana Trestman, Chava Perry, Noam Benyamini, Moshe Mittelman, Yaara Tabib, Tali Bar Lev, Mor Zavaro, Yair Herishanu, Efrat Luttwak, Yael C. Cohen

Research output: Contribution to journal › Article › peer-review

59 Scopus citations

Abstract

Multiple myeloma (MM) patients are at excess risk for clinically significant COVID19 infection. BNT162b2 mRNA COVID19 (BNT162b2) vaccine provides effective protection against COVID19 for the general population, yet its effect in MM patients may be compromised due to disease and therapy-related factors and was not yet evaluated. This single-centre prospective study included MM patients tested for serological response 14–21 days post second vaccine. Vaccinated healthy volunteers served as controls. In all, 171 MM patients, median age 70 (38–94) were included; 159 active MM and 12 smouldering myeloma (SMM). Seropositive response rate (median titer) was 76% (91 U/ml) in active MM patients vs 98% (992 U/ml) in the 64 controls (P < 0·0001), and 100% (822 U/ml) in SMM patients. Multivariate analysis revealed older age (P = 0·009), exposure to ≥4 novel anti-myeloma drugs (P = 0·02) and hypogammaglobulinaemia (P = 0·002) were associated with lower response rates. None of the novel agents significantly decreased response rate, whereas daratumumab trended towards reduced response (P = 0·08). Adverse events occurred in 53% and 55% of the MM patients and controls, respectively, all transient grade 1–2. In conclusion, BNT162b2 vaccine was safe and provided a high seropositivity rate in MM patients, independent of treatment type. Older, hypogammaglobulinaemic and heavily pretreated patients had lower response rates.

Original language	English
Pages (from-to)	186-193
Number of pages	8
Journal	British Journal of Haematology
Volume	195
Issue number	2
DOIs	https://doi.org/10.1111/bjh.17608
State	Published - Oct 2021
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2021 British Society for Haematology and John Wiley & Sons Ltd

Funding

We thank Mrs Doaa Natour, Mrs Einav Kaufman, Mrs Inna Zetserov and Mrs Maayan Jean for coordinating the study and performing the data management. We thank Ronit Benn-Izhak for helping in performing the pre-vaccination serological tests. We thank Gamidor Diagnostics for supplying kits for this study. We thank Dr Tomer Ziv-Baran for his helpful statistical review.

Funders	Funder number
Mrs Doaa Natour, Mrs Einav Kaufman, Mrs Inna Zetserov and Mrs Maayan Jean

Keywords

BNT162b2
COVID19 vaccine
antibody response
multiple myeloma

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1111/bjh.17608

Cite this

Avivi, I., Balaban, R., Shragai, T., Sheffer, G., Morales, M., Aharon, A., Lowenton-Spier, N., Trestman, S., Perry, C., Benyamini, N., Mittelman, M., Tabib, Y., Bar Lev, T., Zavaro, M., Herishanu, Y., Luttwak, E., & Cohen, Y. C. (2021). Humoral response rate and predictors of response to BNT162b2 mRNA COVID19 vaccine in patients with multiple myeloma. British Journal of Haematology, 195(2), 186-193. https://doi.org/10.1111/bjh.17608

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title = "Humoral response rate and predictors of response to BNT162b2 mRNA COVID19 vaccine in patients with multiple myeloma",

abstract = "Multiple myeloma (MM) patients are at excess risk for clinically significant COVID19 infection. BNT162b2 mRNA COVID19 (BNT162b2) vaccine provides effective protection against COVID19 for the general population, yet its effect in MM patients may be compromised due to disease and therapy-related factors and was not yet evaluated. This single-centre prospective study included MM patients tested for serological response 14–21 days post second vaccine. Vaccinated healthy volunteers served as controls. In all, 171 MM patients, median age 70 (38–94) were included; 159 active MM and 12 smouldering myeloma (SMM). Seropositive response rate (median titer) was 76% (91 U/ml) in active MM patients vs 98% (992 U/ml) in the 64 controls (P < 0·0001), and 100% (822 U/ml) in SMM patients. Multivariate analysis revealed older age (P = 0·009), exposure to ≥4 novel anti-myeloma drugs (P = 0·02) and hypogammaglobulinaemia (P = 0·002) were associated with lower response rates. None of the novel agents significantly decreased response rate, whereas daratumumab trended towards reduced response (P = 0·08). Adverse events occurred in 53% and 55% of the MM patients and controls, respectively, all transient grade 1–2. In conclusion, BNT162b2 vaccine was safe and provided a high seropositivity rate in MM patients, independent of treatment type. Older, hypogammaglobulinaemic and heavily pretreated patients had lower response rates.",

keywords = "BNT162b2, COVID19 vaccine, antibody response, multiple myeloma",

author = "Irit Avivi and Roi Balaban and Tamir Shragai and Gabi Sheffer and Miguel Morales and Anat Aharon and Noa Lowenton-Spier and Svetlana Trestman and Chava Perry and Noam Benyamini and Moshe Mittelman and Yaara Tabib and {Bar Lev}, Tali and Mor Zavaro and Yair Herishanu and Efrat Luttwak and Cohen, {Yael C.}",

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year = "2021",

month = oct,

doi = "10.1111/bjh.17608",

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volume = "195",

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Avivi, I, Balaban, R, Shragai, T, Sheffer, G, Morales, M, Aharon, A, Lowenton-Spier, N, Trestman, S, Perry, C, Benyamini, N, Mittelman, M, Tabib, Y, Bar Lev, T, Zavaro, M, Herishanu, Y, Luttwak, E & Cohen, YC 2021, 'Humoral response rate and predictors of response to BNT162b2 mRNA COVID19 vaccine in patients with multiple myeloma', British Journal of Haematology, vol. 195, no. 2, pp. 186-193. https://doi.org/10.1111/bjh.17608

TY - JOUR

T1 - Humoral response rate and predictors of response to BNT162b2 mRNA COVID19 vaccine in patients with multiple myeloma

AU - Avivi, Irit

AU - Balaban, Roi

AU - Shragai, Tamir

AU - Sheffer, Gabi

AU - Morales, Miguel

AU - Aharon, Anat

AU - Lowenton-Spier, Noa

AU - Trestman, Svetlana

AU - Perry, Chava

AU - Benyamini, Noam

AU - Mittelman, Moshe

AU - Tabib, Yaara

AU - Bar Lev, Tali

AU - Zavaro, Mor

AU - Herishanu, Yair

AU - Luttwak, Efrat

AU - Cohen, Yael C.

PY - 2021/10

Y1 - 2021/10

N2 - Multiple myeloma (MM) patients are at excess risk for clinically significant COVID19 infection. BNT162b2 mRNA COVID19 (BNT162b2) vaccine provides effective protection against COVID19 for the general population, yet its effect in MM patients may be compromised due to disease and therapy-related factors and was not yet evaluated. This single-centre prospective study included MM patients tested for serological response 14–21 days post second vaccine. Vaccinated healthy volunteers served as controls. In all, 171 MM patients, median age 70 (38–94) were included; 159 active MM and 12 smouldering myeloma (SMM). Seropositive response rate (median titer) was 76% (91 U/ml) in active MM patients vs 98% (992 U/ml) in the 64 controls (P < 0·0001), and 100% (822 U/ml) in SMM patients. Multivariate analysis revealed older age (P = 0·009), exposure to ≥4 novel anti-myeloma drugs (P = 0·02) and hypogammaglobulinaemia (P = 0·002) were associated with lower response rates. None of the novel agents significantly decreased response rate, whereas daratumumab trended towards reduced response (P = 0·08). Adverse events occurred in 53% and 55% of the MM patients and controls, respectively, all transient grade 1–2. In conclusion, BNT162b2 vaccine was safe and provided a high seropositivity rate in MM patients, independent of treatment type. Older, hypogammaglobulinaemic and heavily pretreated patients had lower response rates.

AB - Multiple myeloma (MM) patients are at excess risk for clinically significant COVID19 infection. BNT162b2 mRNA COVID19 (BNT162b2) vaccine provides effective protection against COVID19 for the general population, yet its effect in MM patients may be compromised due to disease and therapy-related factors and was not yet evaluated. This single-centre prospective study included MM patients tested for serological response 14–21 days post second vaccine. Vaccinated healthy volunteers served as controls. In all, 171 MM patients, median age 70 (38–94) were included; 159 active MM and 12 smouldering myeloma (SMM). Seropositive response rate (median titer) was 76% (91 U/ml) in active MM patients vs 98% (992 U/ml) in the 64 controls (P < 0·0001), and 100% (822 U/ml) in SMM patients. Multivariate analysis revealed older age (P = 0·009), exposure to ≥4 novel anti-myeloma drugs (P = 0·02) and hypogammaglobulinaemia (P = 0·002) were associated with lower response rates. None of the novel agents significantly decreased response rate, whereas daratumumab trended towards reduced response (P = 0·08). Adverse events occurred in 53% and 55% of the MM patients and controls, respectively, all transient grade 1–2. In conclusion, BNT162b2 vaccine was safe and provided a high seropositivity rate in MM patients, independent of treatment type. Older, hypogammaglobulinaemic and heavily pretreated patients had lower response rates.

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Humoral response rate and predictors of response to BNT162b2 mRNA COVID19 vaccine in patients with multiple myeloma

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

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