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Examining the Immunological Responses to Covid-19 Vaccination in Multiple Myeloma Patients: A Systematic Review and Meta-Analysis Publisher Pubmed



Harandi H1, 2 ; Fallahtafti P2, 6 ; Karimi A2, 3 ; Hashemi SM2 ; Mahalleh M2, 5 ; Ashouri M2 ; Salehi MA2 ; Hoveidaei A4
Authors
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Authors Affiliations
  1. 1. Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran

Source: BMC Geriatrics Published:2024


Abstract

Background: Impaired immune response in multiple myeloma renders the patients vulnerable to infections, such as COVID-19, and may cause worse response to vaccines. Researchers should analyze this issue to enable the planning for special preventive measures, such as increased booster doses. Therefore, this meta-analysis aimed to evaluate the response and efficacy of COVID-19 vaccines in patients with multiple myeloma. Methods: This meta-analysis followed PRISMA 2020 guidelines, conducting a comprehensive database search using specified keywords. Study selection involved a two-phase title/abstract and full-text screening process. Data extraction was performed by two researchers, and statistical analysis involved meta-analysis, subgroup analysis based on vaccine dosage and study time, random effects meta-regression, and heterogeneity testing using the Q test. Results: The meta-analysis revealed that patients with multiple myeloma (MM) had a lower likelihood of developing detectable antibodies after COVID-19 vaccination compared to healthy controls (Log odds ratio with 95% CI: -3.34 [-4.08, -2.60]). The analysis of antibody response after different doses showed consistent lower seropositivity in MM patients (after first dose: -2.09, [-3.49, -0.69], second: -3.80, 95%CI [-4.71, -3.01], a booster dose: -3.03, [-5.91, -0.15]). However, there was no significant difference in the mean level of anti-S antibodies between MM patients and controls (Cohen’s d -0.72, [-1.86, 0.43]). Evaluation of T-cell responses indicated diminished T-cell-mediated immunity in MM patients compared to controls. Seven studies reported clinical response, with breakthrough infections observed in vaccinated MM patients. Conclusions: These findings highlight the impaired humoral and cellular immune responses in MM patients after COVID-19 vaccination, suggesting the need for further investigation and potential interventions. © The Author(s) 2024.
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