Response to first vaccination against SARS-CoV-2 in patients with multiple myeloma, Bird et al, Lancet Haematology June 2021
Multiple myeloma is a malignancy of plasma cells, which is highly associated with immune suppression. Consistent with this, reports of outcomes of COVID-19 infection in patients with multiple myeloma show higher rates of severe disease than in the general population.Protection of this vulnerable patient group from COVID-19 infection is crucial but response to the new vaccines in patients with multiple myeloma is unknown. A recent report showing low anti-SARS-CoV-2 IgG response to the Pfizer vaccine in patients with cancer included 38 patients with haematological malignancies (nine patients with multiple myeloma) and showed only a 13% response rate, raising concerns that multiple myeloma might be associated with attenuated vaccine response.
In the UK, both Pfizer and AstraZeneca vaccines have been used with spacing of 12 weeks between the first and second doses. We retrospectively assessed serological response following the first SARS-CoV-2 vaccine dose in patients with multiple myeloma in our centre. Patients were eligible if they had a diagnosis of multiple myeloma and an anti-SARS-CoV-2 spike protein S1 IgG antibody result 21 days or more post-vaccination. Details of the laboratory testing and data analysis are in the appendix (pp 1–2). Data collection and analysis was approved by the Royal Marsden Committee for Clinical Research.
