Determinants of durable humoral and T cell immunity in myeloma patients following COVID-19 vaccination

Clement Twumasi; Sally Moore; Ross Sadler; Sally Jeans; Sherin Varghese; Alison Turner; Gaurav Agarwal; Jemma Larham; Nathanael Gray; Oluremi Carty; Joe Barrett; Stella Bowcock; Udo Oppermann; Vicky Gamble; Gordon Cook; Chara Kyriakou; Mark Drayson; Supratik Basu; Sarah McDonald; Shelagh McKinley; Sarah Gooding; Muhammad K Javaid; Karthik Ramasamy

doi:10.1111/ejh.14143

Determinants of durable humoral and T cell immunity in myeloma patients following COVID-19 vaccination

Eur J Haematol. 2024 Apr;112(4):547-553. doi: 10.1111/ejh.14143. Epub 2023 Dec 20.

Authors

Clement Twumasi^{1

2}, Sally Moore³, Ross Sadler⁴, Sally Jeans⁵, Sherin Varghese⁴, Alison Turner², Gaurav Agarwal⁶, Jemma Larham⁴, Nathanael Gray², Oluremi Carty⁴, Joe Barrett², Stella Bowcock⁷, Udo Oppermann², Vicky Gamble², Gordon Cook⁸, Chara Kyriakou⁹, Mark Drayson¹⁰, Supratik Basu¹¹, Sarah McDonald¹², Shelagh McKinley¹³, Sarah Gooding^{4

14}, Muhammad K Javaid², Karthik Ramasamy^{4

15}

Affiliations

¹ School of Public Health, Imperial College London, Oxford, UK.
² Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
³ Bath Royal United Hospitals, Oxford University Hospitals NHS Trust, Bath, UK.
⁴ Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK.
⁵ The Botnar Research Centre, Headington, UK.
⁶ Medical Sciences Division, University of Oxford, Oxford, UK.
⁷ Department of Haematology, King's College Hospital NHS Trust, London, UK.
⁸ Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
⁹ Department of Haematology, University College London Hospitals NHS Trust, London, UK.
¹⁰ Division of Immunity and Infection, University of Birmingham, Birmingham, UK.
¹¹ Department of Haematology, University of Wolverhampton, Royal Wolverhampton NHS Trust, Wolverhampton, UK.
¹² Blood Cancer UK, London, UK.
¹³ Myeloma UK, Edinburgh, UK.
¹⁴ MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK.
¹⁵ Radcliffe Department of Medicine, Oxford University, Oxford, UK.

PMID: 38116695
DOI: 10.1111/ejh.14143

Abstract

Objective: To describe determinants of persisting humoral and cellular immune response to the second COVID-19 vaccination among patients with myeloma.

Methods: This is a prospective, observational study utilising the RUDYstudy.org platform. Participants reported their second and third COVID-19 vaccination dates. Myeloma patients had an Anti-S antibody level sample taken at least 21 days after their second vaccination and a repeat sample before their third vaccination.

Results: 60 patients provided samples at least 3 weeks (median 57.5 days) after their second vaccination and before their third vaccination (median 176.0 days after second vaccine dose). Low Anti-S antibody levels (<50 IU/mL) doubled during this interval (p = .023) and, in the 47 participants with T-spot data, there was a 25% increase negative T-spot tests (p = .008). Low anti-S antibody levels prior to the third vaccination were predicted by lower Anti-S antibody level and negative T-spot status after the second vaccine. Independent determinants of a negative T-spot included increasing age, previous COVID infection, high CD4 count and lower percentage change in Anti-S antibody levels.

Conclusions: Negative T-spot results predict low Anti-S antibody levels (<50 IU/mL) following a second COVID-19 vaccination and a number of biomarkers predict T cell responses in myeloma patients.

Keywords: COVID-19 vaccination; myeloma; predictors.

Publication types

Observational Study

MeSH terms

Antibodies
Antibodies, Viral
COVID-19 Vaccines
COVID-19* / prevention & control
Humans
Immunity, Cellular
Multiple Myeloma* / therapy
T-Lymphocytes
Vaccination

Substances

COVID-19 Vaccines
Antibodies
Antibodies, Viral

Abstract

Publication types

MeSH terms

Substances

Grants and funding