Recent data suggest a suboptimal antibody response to COVID-19 vaccination in patients with hematological malignancies. Neutralizing antibodies (NAbs) against SARS-CoV-2 were evaluated in 276 patients with plasma cell neoplasms after vaccination with either the BNT162b2 or the AZD1222 vaccine, on days 1 (before the first vaccine shot), 22, and 50. Patients with MM (n = 213), SMM (n = 38), and MGUS (n = 25) and 226 healthy controls were enrolled in the study (NCT04743388). Vaccination with either two doses of the BNT162b2 or one dose of the AZD1222 vaccine leads to lower production of NAbs in patients with MM compared with controls both on day 22 and on day 50 (p < 0.001 for all comparisons). Furthermore, MM patients showed an inferior NAb response compared with MGUS on day 22 (p = 0.009) and on day 50 (p = 0.003). Importantly, active treatment with either anti-CD38 monoclonal antibodies (Mabs) or belantamab mafodotin and lymphopenia at the time of vaccination were independent prognostic factors for suboptimal antibody response following vaccination. In conclusion, MM patients have low humoral response following SARS-CoV-2 vaccination, especially under treatment with anti-CD38 or belamaf. This underlines the need for timely vaccination, possibly during a treatment-free period, and for continuous vigilance on infection control measures in non-responders.

最近的数据表明，血液系统恶性肿瘤患者对 COVID-19 疫苗接种的抗体反应不佳。在接种 BNT162b2 或 AZD1222 疫苗后的第 1 天（第一次疫苗注射前）、第 22 天和第 50 天，对 276 名浆细胞肿瘤患者的 SARS-CoV-2 中和抗体 (NAb) 进行了评估。 MM 患者( n  = 213)、SMM ( n  = 38) 和 MGUS ( n  = 25) 和 226 名健康对照被纳入研究 (NCT04743388)。与对照组相比，在第 22 天和第 50 天接种两剂 BNT162b2 或一剂 AZD1222 疫苗后，MM 患者的 NAb 产量均低于对照组（p < 0.001 所有比较）。此外，与 MGUS 相比，MM 患者在第 22 天 ( p  = 0.009) 和第 50 天 ( p  = 0.003)表现出较差的 NAb 反应。重要的是，在接种疫苗时使用抗 CD38 单克隆抗体 (Mabs) 或 belantamab mafodotin 进行积极治疗和淋巴细胞减少是疫苗接种后抗体反应欠佳的独立预后因素。总之，MM 患者在接种 SARS-CoV-2 疫苗后体液反应较低，尤其是在抗 CD38 或 belamaf 治疗下。这强调了及时接种疫苗的必要性，可能是在无治疗期间，并需要对无反应者的感染控制措施保持警惕。