COVID-19 vaccination in patients with multiple myeloma: a consensus of the European Myeloma Network

Ludwig H, Sonneveld P, Facon T, San-Miguel J, Avet-Loiseau H, Mohty M, Mateos MV, Moreau P, Cavo M, Pawlyn C, Zweegman S, Engelhardt M, Driessen C, Cook G, Dimopoulos MA, Gay F, Einsele H, Delforge M, Caers J, Weisel K, Jackson G, Garderet L, van de Donk N, Leleu X, Goldschmidt H, Beksac M, Nijhof I, Schreder M, Abildgaard N, Hajek R, Zojer N, Kastritis E, Broijl A, Schjesvold F, Boccadoro M, Terpos E (2021)

Publication Type: Journal article, Review article

Publication year: 2021

Journal

Book Volume: 8

Pages Range: e934-e946

Journal Issue: 12

DOI: 10.1016/S2352-3026(21)00278-7

Abstract

Patients with multiple myeloma frequently present with substantial immune impairment and an increased risk for infections and infection-related mortality. The risk for infection with SARS-CoV-2 virus and resulting mortality is also increased, emphasising the importance of protecting patients by vaccination. Available data in patients with multiple myeloma suggest a suboptimal anti-SARS-CoV-2 immune response, meaning a proportion of patients are unprotected. Factors associated with poor response are uncontrolled disease, immunosuppression, concomitant therapy, more lines of therapy, and CD38 antibody-directed and B-cell maturation antigen-directed therapy. These facts suggest that monitoring the immune response to vaccination in patients with multiple myeloma might provide guidance for clinical management, such as administration of additional doses of the same or another vaccine, or even temporary treatment discontinuation, if possible. In those who do not exhibit a good response, prophylactic treatment with neutralising monoclonal antibody cocktails might be considered. In patients deficient of a SARS-CoV-2 immune response, adherence to measures for infection risk reduction is particularly recommended. This consensus was generated by members of the European Multiple Myeloma Network and some external experts. The panel members convened in virtual meetings and conducted an extensive literature research and evaluated recently published data and work presented at meetings, as well as findings from their own studies. The outcome of the discussions on establishing consensus recommendations for COVID-19 vaccination in patients with multiple myeloma was condensed into this Review.

Involved external institutions

LILLE 1 University - Science and Technology France (FR) Universidad de Navarra Spain (ES) Toulouse Oncopole Cancer University Institute (IUCT-O) / Institut universitaire du cancer de Toulouse Oncopole (IUCT-O) France (FR) Sorbonne Université France (FR) Spanish National Research Council / Consejo Superior de Investigaciones Científicas (CSIC) Spain (ES) Nantes University Hospital / Centre hospitalier universitaire de Nantes (CHU) France (FR) Ospedaliero Universitaria di Bologna Policlinico S.Orsola-Malpighi Italy (IT) The Institute of Cancer Research (ICR) United Kingdom (GB) Vrije Universiteit Amsterdam (VU) / University Amsterdam Netherlands (NL) Universitätsklinikum Freiburg Germany (DE) Kantonsspital St.Gallen Switzerland (CH) University of Leeds United Kingdom (GB) Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino Italy (IT) Universitätsklinikum Würzburg Germany (DE) Katholieke Universiteit Leuven (KUL) / Catholic University of Leuven Belgium (BE) Centre Hospitalier Universitaire de Liège (CHU Liège) Belgium (BE) Centre hospitalier universitaire de Poitiers (CHU de Poitiers) France (FR) Universitätsklinikum Heidelberg Germany (DE) Ankara University / Ankara Üniversitesi Turkey (TR) Odense Universitetshospital (OUH) Denmark (DK) Erasmus University Medical Center (MC) Netherlands (NL) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Newcastle upon Tyne Hospitals NHS Foundation Trust United Kingdom (GB) University Hospital Ostrava / Fakultní Nemocnice Ostrava Czech Republic (CZ) Oslo University Hospital / Oslo Universitetssykehus Rikshospitalet Norway (NO) University of Oslo Norway (NO)

How to cite

APA:

Ludwig, H., Sonneveld, P., Facon, T., San-Miguel, J., Avet-Loiseau, H., Mohty, M.,... Terpos, E. (2021). COVID-19 vaccination in patients with multiple myeloma: a consensus of the European Myeloma Network. Lancet Haematology, 8(12), e934-e946. https://doi.org/10.1016/S2352-3026(21)00278-7

MLA:

Ludwig, Heinz, et al. "COVID-19 vaccination in patients with multiple myeloma: a consensus of the European Myeloma Network." Lancet Haematology 8.12 (2021): e934-e946.

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