Cancer Patients With Poor Antibody Response to COVID-19 Vaccines Also Lack Secondary Immune Response, Study Shows
Scientists previously thought patients might mount T cell responses as a second-line protection
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.
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Mount Sinai Health System is one of the nation’s leading integrated academic health systems and one of the largest in the New York metropolitan area. The Health System includes approximately 48,000 employees, more than 9,000 physicians, and 8,600 nurses across seven hospitals, more than 400 outpatient practices, over 600 research and clinical laboratories, a school of nursing, and schools of medicine and graduate school of biomedical sciences.
As a leading learning health system, Mount Sinai combines clinical expertise with scientific discovery to improve patient care while training the next generation of health care and biomedical leaders. The Health System provides care across every stage of life, from prenatal care through geriatrics, while advancing personalized medicine through artificial intelligence, data science, and biomedical research.
Mount Sinai is consistently recognized among the nation’s leading academic health systems for patient care, research, and education. The Mount Sinai Hospital is ranked No. 1 in New York and recognized as one of the world’s top Smart Hospital by Newsweek. The Icahn School of Medicine at Mount Sinai ranks No. 11 among U.S. medical schools for National Institutes of Health (NIH) funding and No. 1 among freestanding medical schools, reflecting the strength of its scientific enterprise and leadership in biomedical research.
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