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Antibody response to pneumococcal vaccination in patients with myelomatosis
Abstract:
17 patients with myelomatosis were vaccinated with a 14-valent pneumococcal capsular polysaccharide vaccine. In comparison to 12 healthy controls, they had statistically significant lower combined geometric mean antibody concentrations (the geometric means of all 14 antigens), both before and 4 weeks after the immunization. Mean antibody increases, however, were remarkably similar in the 2 groups. After 18 months the geometric mean antibody concentrations of the patient group had returned to preimmunization levels or lower for 7 out of 14 antigens. 1 case of pneumococcal bacteraemia occurred in the patient group 8 1/2 months after vaccination in spite of a significant initial antibody response against the infecting serotype 23 F. Pneumococcal vaccination in patients with myelomatosis appears to yield subnormal antibody responses and therefore probably insufficient protection against pneumococcal infection.
Insights
Pneumococcal vaccination in myelomatosis patients shows lower antibody levels compared to healthy individuals. Despite initial similar antibody increases, long-term responses were suboptimal, suggesting potentially insufficient protection against pneumococcal infections.
Area of Science:
- Immunology
- Vaccinology
- Hematology
Background:
- Multiple myeloma (myelomatosis) is a hematologic malignancy associated with impaired immune function.
- Patients with multiple myeloma are at increased risk of severe pneumococcal infections.
- Pneumococcal vaccination is recommended for immunocompromised individuals, but its efficacy in multiple myeloma is not fully understood.
Purpose of the Study:
- To evaluate the immunogenicity of a 14-valent pneumococcal capsular polysaccharide vaccine in patients with myelomatosis.
- To compare antibody responses in myelomatosis patients with those of healthy controls.
Main Methods:
- Seventeen patients with myelomatosis received a 14-valent pneumococcal vaccine.
- Antibody concentrations were measured before vaccination, 4 weeks after, and at 18 months.
- Responses were compared to 12 healthy controls.
Main Results:
- Myelomatosis patients had significantly lower pre- and post-vaccination antibody concentrations than controls.
- Mean antibody increases were similar between groups immediately after vaccination.
- Antibody levels in patients declined to pre-vaccination levels or lower for 7/14 antigens by 18 months.
- One patient developed pneumococcal bacteremia despite an initial response to the infecting serotype.
Conclusions:
- Pneumococcal vaccination in myelomatosis patients elicits subnormal antibody responses.
- The long-term antibody persistence and protective efficacy may be insufficient in this population.
- Further strategies may be needed to ensure adequate protection against pneumococcal disease in myelomatosis patients.