Newswise — New York, NY (October 18, 2021) – Patients with the blood cancer multiple myeloma often mount a poor antibody response to COVID-19 vaccines. Mount Sinai researchers have now discovered that these patients also have a weak response from a different part of the immune system, known as T cells. Their discovery was published in a research letter in Cancer Cell in October.
In a trial of 44 patients with multiple myeloma, those with low or no antibody response to the COVID-19 mRNA also had few or no T cells that could have protected them from a severe COVID-19 infection. T cells are an important component of the immune system and play a central role in the body’s ability to fight off infections, and researchers had believed they might respond even in people with a poor antibody response.
“The unexpected lack of T cell responses, coupled with the absence of antibodies following SARS-CoV-2 vaccination, is of concern and emphasizes the need for serological testing post-vaccination to identify these patients,” said lead author Samir Parekh, MD, Director of Translational Research in Multiple Myeloma at The Tisch Cancer Institute at Mount Sinai and Professor of Medicine (Hematology and Medical Oncology), and Oncological Sciences, at the Icahn School of Medicine at Mount Sinai. “With the current rapid spread of a more transmissible viral variant, the Delta variant, booster vaccination, continuing safety precautions, and passive antibody treatments should be considered to prevent severe disease and death in multiple myeloma patients with poor vaccine responses.”
This study was the first to analyze patients with multiple myeloma and compare their T cell responses to COVID-19 proteins to those in a control group of healthy people. Approximately 96 percent of patients with detectable antibodies against the “spike” protein—an important component of SARS-CoV-2, the virus that causes COVID-19, and a frequent target of vaccines—had detectable COVID-19-specific T cell responses; in contrast, only 35 percent of the patients who had no detectable antibodies had a T cell response. Fewer patients on certain multiple myeloma therapies that impact the immune system had a T cell response compared to those on other therapies.
The team of Mount Sinai researchers continue to study the durability of antibody and T cell responses of these patients after COVID-19 mRNA vaccines and boosters. These findings show that with the current rapid spread of more transmissible viral variants, such as the Delta variant, patients with immune system disorders, including multiple myeloma, should work with their doctors and understand their risk and response to the COVID-19 vaccines. Researchers believe this study underscores high-risk patients’ need for booster vaccination and continued safety precautions such as masking and social distancing.
About the Mount Sinai Health System
The Mount Sinai Health System is New York City's largest academic medical system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. We advance medicine and health through unrivaled education and translational research and discovery to deliver care that is the safest, highest-quality, most accessible and equitable, and the best value of any health system in the nation. The Health System includes approximately 7,300 primary and specialty care physicians; 13 free-standing joint-venture centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, and Long Island; and more than 30 affiliated community health centers. The Mount Sinai Hospital is ranked in U.S. News & World Report's "Honor Roll" of the top 20 U.S. hospitals and among the top in the nation by specialty: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Urology, and Rehabilitation. Mount Sinai Kravis Children's Hospital is ranked in U.S. News & World Report’s “Best Children’s Hospitals” among the country’s best in four out of 10 pediatric specialties. New York Eye and Ear Infirmary of Mount Sinai is ranked among the Top 20 nationally for ophthalmology. The Icahn School of Medicine at Mount Sinai is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools," aligned with a U.S. News & World Report "Honor Roll" Hospital, and No. 14 in the nation for National Institutes of Health funding. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and top five globally, and Mount Sinai Morningside as top 20 globally, and “The World’s Best Specialized Hospitals” ranks Mount Sinai Heart as No. 1 in New York and No. 4 globally and the Division of Gastroenterology as No. 3 globally. For more information, visit https://www.mountsinai.org or find Mount Sinai on Facebook, Twitter and YouTube.
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Cancer Cell, Oct-2021