EBioMedicine (Dec 2023)

Cellular mechanisms associated with sub-optimal immune responses to SARS-CoV-2 bivalent booster vaccination in patients with Multiple MyelomaResearch in context

  • Adolfo Aleman,
  • Morgan van Kesteren,
  • Ariel Kogan Zajdman,
  • Komal Srivastava,
  • Christian Cognigni,
  • Jacob Mischka,
  • Lucia Y. Chen,
  • Bhaskar Upadhyaya,
  • Kseniya Serebryakova,
  • Jessica R. Nardulli,
  • Neko Lyttle,
  • Katerina Kappes,
  • Hayley Jackson,
  • Charles R. Gleason,
  • Annika Oostenink,
  • Gianna Y. Cai,
  • Oliver Van Oekelen,
  • Harm van Bakel,
  • Emilia Mia Sordillo,
  • Carlos Cordon-Cardo,
  • Miriam Merad,
  • Sundar Jagannath,
  • Ania Wajnberg,
  • Viviana Simon,
  • Samir Parekh,
  • Hala Alshammary,
  • Dalles Andre,
  • Radhika Banu,
  • Katherine Beach,
  • María Carolina Bermúdez-González,
  • Ajai Chari,
  • Yuexing Chen,
  • Hearn Cho,
  • Adolfo Firpo,
  • Ana Silvia Gonzalez-Reiche,
  • Eun Hye Kim,
  • Giulio Kleiner,
  • Florian Krammer,
  • Jacob Mauldin,
  • Rao Mendu,
  • Brian Monahan,
  • Shambavi Richard,
  • Joshua Richter,
  • Cesar Rodriguez,
  • Adrianna Rossi,
  • Ashley Salimbangon,
  • Laryssa Sanchez,
  • Daniel Verina

Journal volume & issue
Vol. 98
p. 104886

Abstract

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Summary: Background: The real-world impact of bivalent vaccines for wild type (WA.1) and Omicron variant (BA.5) is largely unknown in immunocompromised patients with Multiple Myeloma (MM). We characterize the humoral and cellular immune responses in patients with MM before and after receiving the bivalent booster, including neutralizing assays to identify patterns associated with continuing vulnerability to current variants (XBB1.16, EG5) in the current post-pandemic era. Methods: We studied the humoral and cellular immune responses before and after bivalent booster immunization in 48 MM patients. Spike binding IgG antibody levels were measured by SARS-CoV-2 spike binding ELISA and neutralization capacity was assessed by a SARS-CoV-2 multi-cycle microneutralization assays to assess inhibition of live virus. We measured spike specific T-cell function using the QuantiFERON SARS-CoV-2 (Qiagen) assay as well as flow-cytometry based T-cell. In a subset of 38 patients, high-dimensional flow cytometry was performed to identify immune cell subsets associated with lack of humoral antibodies. Findings: We find that bivalent vaccination provides significant boost in protection to the omicron variant in our MM patients, in a treatment specific manner. MM patients remain vulnerable to newer variants with mutations in the spike portion. Anti-CD38 and anti-BCMA therapies affect the immune machinery needed to produce antibodies. Interpretation: Our study highlights varying immune responses observed in MM patients after receiving bivalent COVID-19 vaccination. Specifically, a subgroup of MM patients undergoing anti-CD38 and anti-BCMA therapy experience impairment in immune cells such DCs, B cells, NK cells and TFH cells, leading to an inability to generate adequate humoral and cellular responses to vaccination. Funding: National Cancer Institute (National Institutes of Health), National Institute of Allergy and Infectious Diseases (National Institutes of Health), NCI Serological Sciences Network for COVID-19 (SeroNet) and The Icahn School of Medicine at Mount Sinai.

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