A study of 214 patients with myeloma finds that 93% of them produced T cells as well as antibodies to the SARS-CoV-2 spike protein after two doses of a COVID vaccine.
This is the largest study to track T cell as well antibody response after COVID vaccination in myeloma patients, and it found that only 10 patients had no T or B cell immune responses at all. Most of these patients either had poorly controlled myeloma or intensive therapy for the disease, which was likely to have suppressed their immune responses. But once the researchers adjusted for these factors, men were also more likely than women to have a poorer immune response.
“Previous work has found that myeloma patients had a poor immune response to a first dose of the COVID vaccine, so it’s heartening to see that the vast majority of patients did show positive results after both doses of the vaccine,” said Dr Karthik Ramasamy, who led the study.
We plan to continue our research and monitor patients closely to fully understand the extent and length of protection the vaccine delivers, and to identify those who are less likely to be protected so that we can find alternative ways to protect them from COVID.
- Dr Karthik Ramasamy
Myeloma is a type of bone marrow cancer, which often affects several bony areas of the body, such as the spine, skull, the pelvis and the ribs leading to poor quality of life. Treatment for myelomas usually involve medications that destroy the cancer cells, but these can also affect the immune system.
The immune response includes antibodies which can directly bind to foreign pathogens, but also T cells, which can directly attack infected cells and pathogens, as well as supporting other cells to produce antibodies. While previous work has measured antibody responses after COVID-19 vaccination in myeloma patients, this is the first time a UK study has reported encouraging T cells responses after COVID-19 vaccination in these patients.
The researchers used the RUDYstudy.org, an online rare disease platform, to recruit volunteers for the study. They then tested blood serum samples from myeloma patients who had both vaccine doses for antibodies that targeted the virus spike protein, as well as T cells.
Amongst other results, the researchers found that patients whose disease was more poorly controlled when they received the vaccine were more likely to have poor antibody as well as T cell responses.
“This suggests that doctors treating those with myeloma should try and get the disease under as much control as possible before the patients receive the COVID-19 vaccine,” Dr Ramasamy said. “Our results suggest that vaccination should happen where feasible before intensive myeloma treatments begin, since those receiving intensive treatment while they were vaccinated had poorer immune responses.”
The research team are now planning further sampling to track responses in over 300 patients before the third, booster dose of the vaccine, to assess how long the robust immune responses seen in most myeloma patients actually last.
Read the full paper.