ABSTRACT
From September 13 to 15, 2023, the 21st ibausil will take place in Weimar. After a break due to the Covid-19 pandemic, a highlight on the current state of knowledge in the field of building materials. New research and developments regarding the performance of building materials, especially also in the field of cement, lime, gypsum and concrete, will be presented. Another very important item on the program will be sustainable, preferably CO2-neutral or CO2-saving production. Contributions can still be submitted for next year's international conference, and the organizers are looking forward to receiving as broad a spectrum of topics as possible on the current state of research and practice. The extended "Call for Papers" ends on December 31, 2022. In an interview with ZKG Editor-in-Chief Dr. Petra Strunk, Prof. Dr.-Ing. Horst Michael Ludwig went into more detail about the main topics and explained which current and exciting topics await participants at ibausil 2023.
ABSTRACT
The disease- and treatment-induced immunosuppression in MM accounts for a two-fold higher risk for infection with the SARS-CoV-2 virus, an increased risk for a prolonged, severe symptomatic disease, and an increased mortality. Most pts are aware of these risks and show a higher compliance with vaccination recommendations compared to the general population. Several studies revealed differences in the humoral and cellular immune response between pts with MGUS, SMM, and MM, with normal median antibody titers in MGUS, moderately impaired response in SMM, and significantly reduced antibody response in MM, albeit with a wide variation in titers between individual pts. Pts with active, poorly controlled disease and those exposed to CD38 and BCMA-targeting treatments frequently show no or reduced SARS-CoV-2 antibody responses. The EMN issued a consensus that MM pts should ideally be vaccinated before onset of active disease and/or during periods of well controlled disease. A third dose should be administered after an interval of approximately 6 months, and early data in immunocompromised pts show a vaccination response in several previously poorly responding pts after a forth dose. An open question pertains to the role of the interrelationship between the innate, humoral and cellular immune system. Neutralizing antibodies provide the best proxy for protection, although specific thresholds associated with protection against infection are unlikely to be established given the many factors associated with infection control. Antibody titers decline with time from vaccination and more so in vaccinated pts compared to those who have been infected and vaccinated, mandating booster shots in time intervals that need to be established. Pts may present without measurable antibody titers but with detectable cellular immunity or vice versa, although in most reports, correlations between antibody and cellular response were noted. Data suggest that SARSCoV- 2 specific memory B and T cells persist for prolonged periods. One of the threads to patient protection is the substantial mutational activity of the SARS-CoV-2 virus with reduced neutralizing capacity of vaccine induced antibodies against recent variants of concern, particularly the omicron variant, posing vaccinated pts at risk for breakthrough infections. Recent research efforts resulted in new prophylactic treatments for pts with high risk for severe COVID-19 disease (Table 1) that have been shown to reduce the incidence of severe complications. .
ABSTRACT
Background: Infections are the second leading cause of death in multiple myeloma (MM). All available measures to curb this complication should be exploited, including vaccination against several bacteria and viruses. Aims: In this study, we examined the recommendations for vaccination given to patients (pts) with MM in real-world clinical practice and pts' compliance with them. We also analyzed the incidence of infections before and after diagnosis, and pts' willingness to be vaccinated against COVID-19. Methods: 335 pts with MM from Germany, Switzerland, and Austria participated in this survey. A questionnaire was designed in cooperation with pts groups to assess the vaccination recommendations given to them from their treating physicians, to evaluate their compliance with the advice received, to capture the infection rate of pts in the year before and the first six months after start of therapy, and to assess pts' willingness to be vaccinated against COVID-19. The invitation to participate in this electronic survey was distributed by 31 participating myeloma support groups. In addition, 500 hardcopy questionnaires were mailed directly to pts, reaching out to approximately 2,000 pts. Results: Pts' median age was 65 years;23.0% had 1, 34.8% 2-3, and 42.3% ≥ 4 lines of prior treatment. Pts' responses were similar between respondents to the online and printed version of the questionnaire. The number of pts who received recommendations for the various vaccinations and the proportion of pts who actually received the vaccine is shown in Figure 1. Influenza was the most frequently recommended vaccine (77.0%), followed by pneumococci (65.4%). Pts' compliance with their physicians' advice varied between 67% and 90%. At least one infectious period in the year preceding the diagnosis of MM was reported by 51.9% of the 322 responding pts, and by 42.4% of the 314 responding pts during the first six months after initiation of firstline therapy. Eighty-three percent of pts declared their willingness to be vaccinated against COVID-19, while 17% stated that they objected to it. Reasons for refusing SARS-CoV-2 vaccination were lack of long-term experience (76.6%), concerns regarding late effects (60.9%), insufficient confidence in the pharmaceutical industry (26.7%), and concerns that the vaccine will not be protective (15.6%). Summary/Conclusion: The vaccination recommendations varied widely depending on the type of vaccine, but compliance with these recommendations was remarkably high (>80%) for influenza, pneumococci, hepatitis B, and DTP. The high rates of recommendations for influenza and pneumococci seem to reflect the high prevalence of upper and lower respiratory tract infections in MM. Of note, 51.9% of pts reported a least one infectious episode in the year before, and 42.4% during the first six months after initiation of treatment. As 75.4% of pts did receive prior ASCT, vaccinations with DTP and MMR were recommended to substantial pt numbers. In contrast, fewer than expected pts were advised to get vaccinated against VZV (28%) and against Haemophilus influenzae (12.8%). Tick borne encephalitis is endemic in the some areas of the participating countries, which possibly explains the high compliance rate (78.8%) in the 26.8% of pts who were advised to be vaccinated. The high readiness of MM pts to get vaccinated with a SARS-CoV-2 vaccine (83%) seems remarkable and much higher than that of the general population. A possible explanation for this proactive attitude is the preferential participation of well-informed pts in this study.