Breakthrough Infections in SARS-CoV-2-Vaccinated Multiple Myeloma Patients Improve Cross-Protection against Omicron...

Area of Science:

• Immunology
• Oncology
• Infectious Diseases

Background:

• Multiple myeloma (MM) patients are immunocompromised with high COVID-19 risks.
• mRNA SARS-CoV-2 vaccination responses are impaired in MM patients.
• Booster effects and cross-protection against variants in MM are understudied.

Purpose of the Study:

• Evaluate humoral and cellular vaccine responses in MM patients.
• Assess antibody levels and cross-protection to SARS-CoV-2 variants of concern (VOCs).
• Stratify MM patients by disease stage and treatment for response analysis.

Main Methods:

• Prospective cohort study analyzing vaccine responses in MM patients and healthy subjects.
• Stratification of MM patients into four groups based on disease status and treatment.
• Measurement of antibody levels, neutralization capacity, and B memory cell formation.

Main Results:

• Most MM patients had low Omicron-specific antibodies and cross-neutralization post-boosters.
• Progressed MM patients on anti-CD38 mAb and post-immunotherapy SCT showed delayed B cell responses.
• Hybrid immunity (vaccination + breakthrough infection) enhanced cross-protection against VOCs without severe disease.

Conclusions:

• MM patients need frequent, variant-adapted booster vaccinations or alternative vaccine strategies.
• Immunological effects similar to breakthrough infections may be beneficial.
• Further research into optimized vaccination protocols for MM patients is crucial.