ABSTRACT
Multiple myeloma (MM) patients are at risk of fatal outcome after SARS-CoV-2 infection. Preliminary data suggest that MM patients have an impaired response to vaccination. This prospective study analyzed the humoral and cellular immune responses to two doses of BNT162b2 in 72 MM patients, including 48 receiving anti-CD38 immunotherapy. Results evidenced that MM patients display lower levels of SARS-CoV-2 specific IgG and IgA antibodies and decreased neutralization of alpha and delta variants when compared to healthy controls. They also showed decreased numbers of circulating IFN{gamma}-producing Spike SARS-CoV-2 specific T lymphocytes. This defective immune response was particularly marked in patients receiving anti-CD38 immunotherapy. Furthermore, a retrospective investigation of MM patients among COVID-19-related death in the Paris area suggested a limited efficacy of BNT162b2 in patients treated with anti-CD38. Overall, these results show a decreased immunogenicity of BNT162b2 in MM patients and stress the need for novel strategies to improve SARS-CoV-2 prophylaxis in immunocompromised individuals.
Subject(s)
COVID-19 , Multiple MyelomaABSTRACT
Background : Datas from China suggest that patients with cancer have more severe outcome in case of covid-19 infection. Patients with haematological disease have often immunosuppression, due to the underlying disease and to their treatment. Methods: We recorded the consecutive patients usually treated in our haematology department diagnosed with COVID-19 infection between March 10th to April 30th. To evaluate the impact of the pandemic, we compare the activity of our department during two twenty working-days periods: March 20th to April 17th (“Covid month”) and February 18th to March 16th 2020 (“Covid-free month”). Results: Fifty patients treated in our haematology department had a COVID-19 infection, diagnosed with PCR or CT-scanner. Half of them were still on chemotherapy treatment, 30% were on survey after treatment and 20% were on a “watch and wait” strategy. Sixteen patients ( 30%) evolved to an acute respiratory syndrome with a fatal outcome in ten cases. (20%). The severity of the disease prompted us to change the organization of our department to protect our patients. We followed international recommendation and delayed non urgent procedure. this allowed a reduction of 10% of our activity. Moreover, we managed to treat 25% of our patients coming usually in outpatient clinic with tele-health. Thanks to hospital-at-home, these patients could receive their treatment and stay safe at home. Conclusion: This retrospective study give an insight of how covid-19 outbreak will change cancer care.