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Third dose of an mRNA COVID-19 vaccine for patients with multiple myeloma.
Goldwater, Marissa-Skye; Stampfer, Samuel D; Sean Regidor, Bernard; Bujarski, Sean; Jew, Scott; Chen, Haiming; Xu, Ning; Kim, Clara; Kim, Susanna; Berenson, James R.
  • Goldwater MS; Institute for Myeloma and Bone Cancer Research, West Hollywood, CA, United States.
  • Stampfer SD; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States.
  • Sean Regidor B; Berenson Cancer Center, West Hollywood, CA, United States.
  • Bujarski S; Institute for Myeloma and Bone Cancer Research, West Hollywood, CA, United States.
  • Jew S; Institute for Myeloma and Bone Cancer Research, West Hollywood, CA, United States.
  • Chen H; Institute for Myeloma and Bone Cancer Research, West Hollywood, CA, United States.
  • Xu N; Institute for Myeloma and Bone Cancer Research, West Hollywood, CA, United States.
  • Kim C; ONCOtherapeutics, West Hollywood, CA, United States.
  • Kim S; ONCOtherapeutics, West Hollywood, CA, United States.
  • Berenson JR; Institute for Myeloma and Bone Cancer Research, West Hollywood, CA, United States.
Clin Infect Pract ; 17: 100214, 2023 Jan.
Article in English | MEDLINE | ID: covidwho-2158604
ABSTRACT
We have reported that IgG antibody responses following two mRNA COVID-19 vaccinations are impaired among patients with multiple myeloma (MM). In the current study, sixty-seven patients with MM were tested for anti-spike IgG antibodies 0-60 days prior to their first vaccination, 14-28 days following the second dose, and both before and 14-28 days after their third dose of the mRNA-1273 or BNT162b2 vaccines. After the first two doses, most patients' (93 %) antibody levels declined to ineffective levels (<250 BAU/mL) prior to their third dose (D3). D3 elicited responses in 84 % of patients (61 % full response and 22 % partial response). The third vaccination increased antibody levels (average = 370.4 BAU/mL; range, 1.0-8977.3 BAU/mL) relative to just prior to D3 (average = 25.0 BAU/mL; range, 1.0-683.8 BAU/mL) and achieved higher levels than peak levels after the first two doses (average = 144.8 BAU/mL; range, 1.0-4,284.1 BAU/mL). D3 response positively correlated with mRNA-1273, a > 10-fold change from baseline for the two-dose series, switching from BNT162b2 to mRNA-1273 for D3, and treatment with elotuzumab and an immunomodulatory agent. Lower antibody levels prior to D3, poorer overall response to first two doses, and ruxolitinib or anti-CD38 monoclonal antibody treatment negatively correlated with D3 response. Our results show encouraging activity of the third vaccine, even among patients who failed to respond to the first two vaccinations. The finding of specific factors that predict COVID-19 antibody levels will help advise patients and healthcare professionals on the likelihood of responses to further vaccinations.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Topics: Vaccines Language: English Journal: Clin Infect Pract Year: 2023 Document Type: Article Affiliation country: J.clinpr.2022.100214

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Topics: Vaccines Language: English Journal: Clin Infect Pract Year: 2023 Document Type: Article Affiliation country: J.clinpr.2022.100214