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

Abstract

AbstractObjectiveTo describe determinants of persisting humoral and cellular immune response to the second COVID‐19 vaccination among patients with myeloma.MethodsThis 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.Results60 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.ConclusionsNegative 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.