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Antibody response to pneumococcal vaccine in patients with multiple myeloma
Abstract:
Patients with multiple myeloma and Waldenström's macroglobulinemia respond poorly to antigenic stimuli and may not be protected by pneumococcal vaccine. Thirty-seven patients and 10 controls received 14-valent pneumococcal capsular polysaccharide vaccine. The patients had lower (P less than 0.01) titers of antibody to 11 of the 12 antigens assayed before vaccination and to 10 of 12 antigens (P less than 0.01) after vaccination than did controls, but the ratios of antibody titers before vaccination to those after vaccination were remarkably similar. A poorer antibody response was observed in patients receiving multiagent chemotherapy than in those receiving chemotherapy with alkylating agents (P less than 0.01 for six of the antigens). That these patients did respond to the vaccine (although titers of antibody after vaccination were significantly lower than those in controls) suggests that patients with multiple myeloma or macroglobulinemia may benefit from pneumococcal vaccine.
Insights
Patients with multiple myeloma and Waldenström's macroglobulinemia show a reduced antibody response to pneumococcal vaccine compared to controls. However, the similar antibody titer ratios suggest potential vaccine benefit despite lower overall titers.
Area of Science:
- Immunology
- Hematology
- Vaccinology
Background:
- Patients with multiple myeloma and Waldenström's macroglobulinemia exhibit impaired immune responses to antigens.
- These patients may have insufficient protection from standard pneumococcal vaccination.
Purpose of the Study:
- To evaluate the immunogenicity of a 14-valent pneumococcal capsular polysaccharide vaccine in patients with multiple myeloma and Waldenström's macroglobulinemia.
- To compare antibody responses between patients and healthy controls and assess the impact of chemotherapy.
Main Methods:
- Thirty-seven patients and 10 controls were administered a 14-valent pneumococcal vaccine.
- Antibody titers against 12 pneumococcal antigens were measured before and after vaccination.
- Patient responses were analyzed in relation to chemotherapy regimens.
Main Results:
- Patients demonstrated significantly lower pre- and post-vaccination antibody titers compared to controls (P < 0.01).
- The ratio of pre- to post-vaccination antibody titers was similar between patients and controls.
- Patients on multiagent chemotherapy showed a poorer response than those on alkylating agents (P < 0.01).
Conclusions:
- Despite lower antibody titers, the similar response ratios suggest that patients with multiple myeloma or Waldenström's macroglobulinemia may still derive benefit from pneumococcal vaccination.
- Chemotherapy type influences vaccine immunogenicity in these patient populations.