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Objective: To describe determinants of persisting humoral and cellular immune response to the second COVID‐19 vaccination among patients with myeloma. Methods: This is a prospective, observational study utilising the RUDYstudy.org platform. Participants reported their second and third COVID‐19 vaccination dates. Myeloma patients had an Anti‐S antibody level sample taken at least 21 days after their second vaccination and a repeat sample before their third vaccination. Results: 60 patients provided samples at least 3 weeks (median 57.5 days) after their second vaccination and before their third vaccination (median 176.0 days after second vaccine dose). Low Anti‐S antibody levels (<50 IU/mL) doubled during this interval (p =.023) and, in the 47 participants with T‐spot data, there was a 25% increase negative T‐spot tests (p =.008). Low anti–S antibody levels prior to the third vaccination were predicted by lower Anti‐S antibody level and negative T‐spot status after the second vaccine. Independent determinants of a negative T‐spot included increasing age, previous COVID infection, high CD4 count and lower percentage change in Anti‐S antibody levels. Conclusions: Negative T‐spot results predict low Anti‐S antibody levels (<50 IU/mL) following a second COVID‐19 vaccination and a number of biomarkers predict T cell responses in myeloma patients. [ABSTRACT FROM AUTHOR]

Objective: Myeloma is primarily a disease of the elderly, but older patients experience poorer outcomes. Effective treatments may not be offered to older patients over fears about toxicity, particularly for those with comorbidities. We aimed to characterise the trend in survival disparity between older and younger patients and assess to what extent comorbidity might explain these disparities. Methods: We examined records for 56 010 patients diagnosed with myeloma in England between 1998‐2014. The Hospital Episode Statistics database provided information on comorbidity. Net survival was estimated for each diagnosis period. Adjusted excess hazard ratios for the effect of age were estimated using flexible parametric models. Results: Net survival increased for all age groups over the study period. However, older patients experienced a higher risk of death from their disease consistent between 1998 and 2014. Adjusting for comorbidity made little difference to the estimates. Conclusion: Factors other than comorbidity must explain the poorer survival experience of elderly patients. Treatment data were not examined and should be employed by future population studies. Inconsistent treatment of elderly patients with myeloma may be prevented by further use of pragmatic clinical trials which are inclusive of older adults, and also wider utilisation of frailty scores. [ABSTRACT FROM AUTHOR]