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

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.
Competing Interests: Declaration of interests HL declares research funding from Amgen and Takeda, and speaker's honoraria from and participation on advisory boards for Amgen, Takeda, Sanofi, Janssen, Celgene-Bristol Myers Squibb, and Seattle Genetics. PS declares research funding from Amgen, Celgene-Bristol Myers Squibb, Janssen, SkylineDx, and Takeda, and honoraria from and participation on advisory boards for Amgen, Celgene-Bristol Myers Squibb, Janssen, SkylineDx, and Takeda. TF declares participation on advisory boards for Janssen, Bristol Myers Squibb, Takeda, Amgen, Roche, Karyopharm, Oncopeptides, and Abbvie, and speaker's honoraria from Janssen and Bristol Myers Squibb. JS-M declares consulting fees from and participation on advisory boards for Amgen, Celgene-Bristol Myers Squibb, Janssen, MSD, Novartis, Takeda, Sanofi, Roche, Abbvie, GlaxoSmithKline, Regeneron, SecuraBio, and Karyopharm. M-VM declares honoraria from and participation on advisory boards for Janssen, Celgene-Bristol Myers Squibb, Takeda, Amgen, Sanofi, Oncopeptides, GlaxoSmithKline, Adaptive, Pfizer, Regeneron, Roche, Sea-Gen, and Blu Bird bio. PM declares honoraria from and participation on advisory boards for Janssen, Celgene-Bristol Myers Squibb, Amgen, Sanofi, and Abbvie. MC declares honoraria from Janssen, Celgene-Bristol Myers Squibb, GlaxoSmithKline, Amgen, Takeda, AbbVie, and Sanofi, and participation on advisory boards for Janssen, Celgene-Bristol Myers Squibb, GlaxoSmithKline, Amgen, Takeda, AbbVie, and Sanofi. CP declares consultancy fees from Amgen, Takeda, Celgene-Bristol Myers Squibb, and Sanofi; travel support from Amgen, Takeda, Janssen, and Celgene-Bristol Myers Squibb; and honoraria from Janssen, Celgene-Bristol Myers Squibb, and Sanofi. SZ declares research funding from Takeda and Janssen, and participation on advisory boards for Takeda, Janssen, Sanofi, Bristol Myers Squibb, and Oncopeptides. ME declares honoraria from and participation on advisory boards for Amgen, Celgene-Bristol Myers Squibb, GlaxoSmithKline, Janssen, Karyopharm, Sanofi, and Takeda, and research funding from Amgen, Celgene-Bristol Myers Squibb, Janssen, Karyopharm, and Takeda. GC declares honoraria from and participation on advisory boards for Celgene-Bristol Myers Squibb, Takeda, GlaxoSmithKline, Sanofi, Amgen, Janssen, and Oncopeptides, and research funding from GlaxoSmithKline and Takeda. MAD declares participation on advisory boards for Amgen, Takeda, Bristol Myers Squibb, Janssen, and Beigene. FG declares honoraria from Amgen, Janssen, Takeda, Celgene-Bristol Myers Squibb, AbbVie, and GlaxoSmithKline, and participation on advisory boards for Amgen, Celgene-Bristol Myers Squibb, Janssen, Takeda, AbbVie, GlaxoSmithKline, Roche, Adaptive Biotechnologies, Oncopeptides, and Bluebird Bio. HE declares honoraria from Amgen, Celgene-Bristol Myers Squibb, Janssen, Takeda, GlaxoSmithKline, Sanofi, Novartis; consultancy fees from and participation on advisory boards for Amgen, Celgene-Bristol Myers Squibb, Janssen, Takeda, GlaxoSmithKline, Sanofi, and Novartis; and research funding from Amgen, Celgene-Bristol Myers Squibb, Janssen, Sanofi, and GlaxoSmithKline. MD declares speaker's honoraria and research funding from Amgen, Celgene-Bristol Myers Squibb, Janssen, Sanofi, and Takeda. KW declares research funding from Amgen, Celgene-Bristol Myers Squibb, Janssen, and Sanofi, and honoraria from Amgen, Abbvie, Adaptive Biotech, Celgene-Bristol Myers Squibb, Janssen, Karyopharm, Novartis, Oncopeptides, Roche Pharma, Takeda, and Sanofi. GJ declares speaker's honoraria from and participation on advisory boards for Celgene-Bristol Myers Squibb, Takeda, GlaxoSmithKline, Sanofi, Amgen, Johnson & Johnson, and Oncopeptides, and research funding from Celgene-Bristol Myers Squibb and Takeda. LG declares participation on advisory boards for Amgen, Takeda, Celgene-Bristol Myers Squibb, and Janssen. NvdD declares research funding from Janssen Pharmaceuticals, Amgen, Celgene-Bristol Myers Squibb, Novartis, and Cellectis, and participation on advisory boards for Janssen Pharmaceuticals, Amgen, Celgene-Bristol Myers Squibb, Takeda, Roche, Novartis, Bayer, Servier, GlaxoSmithKline, and Sanofi. XL declares honoraria from Janssen-Cilag, Celgene-Bristol Myers Squibb, Amgen, Novartis, Takeda, Sanofi, Abbvie, Merck, Roche, Karyopharm Therapeutics, Carsgen Therapeutics, Oncopeptides, and GlaxoSmithKline; consulting and advisory roles for Janssen-Cilag, Celgene-Bristol Myers Squibb, Amgen, Takeda, Novartis, Merck, Gilead Sciences, Abbvie, Roche, Karyopharm Therapeutics, Oncopeptides, Carsgen Therapeutics, and GlaxoSmithKline; travel fees from Accommodations; and expenses from Takeda. HG declares grants and provision of Investigational Medicinal Product Amgen, Celgene-Bristol Myers Squibb, Chugai, Janssen, and Sanofi; research support from Amgen, Celgene-Bristol Myers Squibb, Chugai, Janssen, Incyte, Molecular Partners, MSD, Sanofi, Mundipharma GmbH, Takeda, and Novartis; participation on advisory boards for Adaptive Biotechnology, Amgen, Celgene-Bristol Myers Squibb, Janssen, Sanofi, and Takeda; and honoraria from Amgen, Celgene-Bristol Myers Squibb, Chugai, GlaxoSmithKline, Janssen, Novartis, and Sanofi. MeB declares participation on advisory boards for Amgen, Celgene-Bristol Myers Squibb, Janssen, Sanofi, Takeda, and Oncopeptides, and speaker's honoraria from Amgen, Celgene-Bristol Myers Squibb, Janssen, Sanofi, and Takeda. IN declares Advisory Boards and Honoraria: Amgen, Janssen, Celgene-Bristol Myers Squibb. MS declares speaker's honoraria and participation on advisory boards for Celgene-Bristol Myers Squibb, Amgen, Takeda, Janssen, and GlaxoSmithKline. NA declares research funding from Celgene-Bristol Myers Squibb, Amgen, Janssen, and Takeda. RH declares consultancy fees from and participation on advisory boards for Janssen, Amgen, AbbVie, Bristol Myers Squibb, Novartis, PharmaMar, and Takeda; honoraria from Janssen, Amgen, Bristol Myers Squibb, PharmaMar, and Takeda; and research funding from Janssen, Amgen, Bristol Myers Squibb, Novartis, and Takeda. NZ declares speaker's honoraria and participation on advisory boards for Celgene-Bristol Myers Squibb, Amgen, Takeda, Janssen, and Sanofi. EK declares consultancy fees and honoraria from and participation on advisory boards for Amgen, Genesis Pharma, Takeda, Janssen, and Pfizer Sanofi. AB declares honoraria from and participation on advisory boards for Amgen, Janssen, Celgene-Bristol Myers Squibb, and Sanofi. FS declares honoraria from Amgen, Celgene, Janssen, MSD, Novartis, Oncopeptides, Sanofi, SkyliteDX, and Takeda, and membership on an entity's advisory committees for Amgen, Celgene-Bristol Myers Squibb, Janssen, MSD, Novartis, Oncopeptides, Sanofi, and Takeda. MaB declares honoraria from Sanofi, Celgene-Bristol Myers Squibb, Amgen, Janssen, Novartis, and AbbVie; participation on advisory boards for Janssen and GlaxoSmithKline; and research funding from Sanofi, Celgene-Bristol Myers Squibb, Amgen, Janssen, Novartis, and Mundipharma. ET declares consultancy fees and honoraria from Amgen, Celgene-Bristol Myers Squibb, Janssen, Takeda, Genesis Pharma, GlaxoSmithKline, and Sanofi, and research support from Amgen, Janssen, Celgene-Bristol Myers Squibb, Genesis Pharma, GlaxoSmithKline, and Sanofi. HA-L, MM, CD, and JC declare no competing interests.
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