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Nooka AK, Shanmugasundaram U, Cheedarla N, Verkerke H, Edara VV, Valanparambil R, Kaufman JL, Hofmeister CC, Joseph NS, Lonial S, Azeem M, Manalo J, Switchenko JM, Chang A, Linderman SL, Roback JD, Dhodapkar KM, Ahmed R, Suthar MS, Neish AS, Dhodapkar MV. Determinants of Neutralizing Antibody Response After SARS CoV-2 Vaccination in Patients With Myeloma. J Clin Oncol 2022; 40:3057-3064. [PMID: 35259002 PMCID: PMC9462534 DOI: 10.1200/jco.21.02257] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Vaccine-induced neutralizing antibodies (nAbs) play a critical role in protection from SARS CoV-2. Patients with B-cell malignancies including myeloma are at increased risk of COVID-19-related mortality and exhibit variable serologic response to the vaccine. The capacity of vaccine-induced antibodies in these patients to neutralize SARS CoV-2 or its variants is not known. METHODS Sera from 238 patients with multiple myeloma (MM) undergoing SARS CoV-2 vaccination were analyzed. Antibodies against the SARS CoV-2 spike receptor-binding domain (RBD) and viral nucleocapsid were measured to detect serologic response to vaccine and environmental exposure to the virus. The capacity of antibodies to neutralize virus was quantified using pseudovirus neutralization assay and live virus neutralization against the initial SARS CoV-2 strain and the B1.617.2 (Delta) variant. RESULTS Vaccine-induced nAbs are detectable at much lower rates (54%) than estimated in previous seroconversion studies in MM, which did not monitor viral neutralization. In 33% of patients, vaccine-induced antispike RBD antibodies lack detectable neutralizing capacity, including against the B1.617.2 variant. Induction of nAbs is affected by race, disease, and treatment-related factors. Patients receiving mRNA1273 vaccine (Moderna) achieved significantly greater induction of nAbs compared with those receiving BNT162b2 (Pfizer; 67% v 48%, P = .006). CONCLUSION These data show that vaccine-induced antibodies in several patients with MM lack detectable virus-neutralizing activity. Vaccine-mediated induction of nAbs is affected by race, disease, vaccine, and treatment characteristics. These data have several implications for the emerging application of booster vaccines in immunocompromised hosts.
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Affiliation(s)
- Ajay K Nooka
- Department of Hematology/Medical Oncology, Emory University, Atlanta, GA.,Winship Cancer Institute, Atlanta, GA
| | | | - Narayana Cheedarla
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA
| | - Hans Verkerke
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA
| | - Venkata V Edara
- Emory Vaccine Center, Emory University, Atlanta, GA.,Yerkes National Primate Center, Atlanta, GA
| | - Rajesh Valanparambil
- Emory Vaccine Center, Emory University, Atlanta, GA.,Yerkes National Primate Center, Atlanta, GA
| | - Jonathan L Kaufman
- Department of Hematology/Medical Oncology, Emory University, Atlanta, GA.,Winship Cancer Institute, Atlanta, GA
| | - Craig C Hofmeister
- Department of Hematology/Medical Oncology, Emory University, Atlanta, GA.,Winship Cancer Institute, Atlanta, GA
| | - Nisha S Joseph
- Department of Hematology/Medical Oncology, Emory University, Atlanta, GA.,Winship Cancer Institute, Atlanta, GA
| | - Sagar Lonial
- Department of Hematology/Medical Oncology, Emory University, Atlanta, GA.,Winship Cancer Institute, Atlanta, GA
| | - Maryam Azeem
- Department of Hematology/Medical Oncology, Emory University, Atlanta, GA
| | - Julia Manalo
- Department of Hematology/Medical Oncology, Emory University, Atlanta, GA
| | | | - Andres Chang
- Department of Hematology/Medical Oncology, Emory University, Atlanta, GA.,Winship Cancer Institute, Atlanta, GA
| | | | - John D Roback
- Winship Cancer Institute, Atlanta, GA.,Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA
| | - Kavita M Dhodapkar
- Winship Cancer Institute, Atlanta, GA.,Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University, Atlanta, GA
| | - Rafi Ahmed
- Winship Cancer Institute, Atlanta, GA.,Emory Vaccine Center, Emory University, Atlanta, GA
| | - Mehul S Suthar
- Emory Vaccine Center, Emory University, Atlanta, GA.,Yerkes National Primate Center, Atlanta, GA.,Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta, Department of Pediatrics and Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA
| | - Andrew S Neish
- Winship Cancer Institute, Atlanta, GA.,Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA
| | - Madhav V Dhodapkar
- Department of Hematology/Medical Oncology, Emory University, Atlanta, GA.,Winship Cancer Institute, Atlanta, GA
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Patel PA, Lapp SA, Grubbs G, Edara VV, Rostad CA, Stokes CL, Pauly MG, Anderson EJ, Piantadosi A, Suthar MS, Khurana S, Sabnis HS. Immune responses and therapeutic challenges in paediatric patients with new-onset acute myeloid leukaemia and concomitant COVID-19. Br J Haematol 2021; 194:549-553. [PMID: 34096051 PMCID: PMC8239563 DOI: 10.1111/bjh.17517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Pratik A Patel
- Department of Pediatrics, Division of Hematology/Oncology/Bone Marrow Transplantation, Emory University School of Medicine, Atlanta, GA, USA.,Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Stacey A Lapp
- Department of Pediatrics, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.,Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Gabrielle Grubbs
- Division of Viral Products, Center for Biologics Evaluation and Research, FDA, Silver Spring, MD, USA
| | - Venkata V Edara
- Department of Pediatrics, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.,Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, GA, USA.,Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA.,Yerkes Primate Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Christina A Rostad
- Department of Pediatrics, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.,Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Claire L Stokes
- Department of Pediatrics, Division of Hematology/Oncology/Bone Marrow Transplantation, Emory University School of Medicine, Atlanta, GA, USA.,Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Melinda G Pauly
- Department of Pediatrics, Division of Hematology/Oncology/Bone Marrow Transplantation, Emory University School of Medicine, Atlanta, GA, USA.,Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Evan J Anderson
- Department of Pediatrics, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.,Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, GA, USA.,Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Anne Piantadosi
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.,Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA
| | - Mehul S Suthar
- Department of Pediatrics, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.,Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, GA, USA.,Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA.,Yerkes Primate Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Surender Khurana
- Division of Viral Products, Center for Biologics Evaluation and Research, FDA, Silver Spring, MD, USA
| | - Himalee S Sabnis
- Department of Pediatrics, Division of Hematology/Oncology/Bone Marrow Transplantation, Emory University School of Medicine, Atlanta, GA, USA.,Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
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