Anti-bacterial Antibodies in Multiple Myeloma Patients at Disease Presentation, in Response to Therapy and in Remission: Implications for Patient Management

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Anti-bacterial Antibodies in Multiple Myeloma Patients at Disease Presentation, in Response to Therapy and in Remission: Implications for Patient Management. / Chicca, Ilaria; Heaney, Jennifer; Iqbal, Gulnaz; Dunn, Janet; Bowcock, Stella; Pratt, Guy; Yong, Kwee ; Planche, Timothy ; Richter, Alex; Drayson, Mark.

In: Blood Cancer Journal, Vol. 10, No. 11, 114, 04.11.2020.

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@article{0d7b9162240a4a2bb338813ec9cf1d6b,
title = "Anti-bacterial Antibodies in Multiple Myeloma Patients at Disease Presentation, in Response to Therapy and in Remission: Implications for Patient Management",
abstract = "Multiple myeloma (MM) is associated with increased risk of infection, but little is known regarding antibody levels against specific bacteria. We assessed levels of polyclonal immunoglobulin and antibacterial antibodies in patients recruited to the TEAMM trial, a randomised trial of antibiotic prophylaxis at the start of anti-myeloma treatment. Polyclonal IgG, IgA and IgM levels were below the reference range in 71%, 83% and 90% of 838 MM patients at diagnosis. Anti-vaccine targeted tetanus toxoid antibodies were protective in 95% of 193 healthy controls but only 41% of myeloma patients. In healthy controls, protective antibodies against 6/12 pneumococcal serotypes, haemophilus and meningococcus A were present in 67%, 41% and 56% compared to just 15%, 21% and 17% of myeloma patients. By 1 year, myeloma patients IgG levels had recovered for 57% of patients whilst the proportion with protective levels of IgG against thymus-dependent protein antigen tetanus toxoid had changed little. In contrast the proportions of patients with protective levels against thymus independent polysaccharide antigens pneumococcus, haemophilus and meningococcus had fallen from 15 to 7%, 21 to 0% and 17 to 11%. Findings highlight the need for strategies to protect patients against bacterial infections during therapy and vaccination programmes during remission.",
author = "Ilaria Chicca and Jennifer Heaney and Gulnaz Iqbal and Janet Dunn and Stella Bowcock and Guy Pratt and Kwee Yong and Timothy Planche and Alex Richter and Mark Drayson",
year = "2020",
month = nov,
day = "4",
doi = "10.1038/s41408-020-00370-7",
language = "English",
volume = "10",
journal = "Blood Cancer Journal",
issn = "2044-5385",
publisher = "Nature Publishing Group",
number = "11",

}

RIS

TY - JOUR

T1 - Anti-bacterial Antibodies in Multiple Myeloma Patients at Disease Presentation, in Response to Therapy and in Remission: Implications for Patient Management

AU - Chicca, Ilaria

AU - Heaney, Jennifer

AU - Iqbal, Gulnaz

AU - Dunn, Janet

AU - Bowcock, Stella

AU - Pratt, Guy

AU - Yong, Kwee

AU - Planche, Timothy

AU - Richter, Alex

AU - Drayson, Mark

PY - 2020/11/4

Y1 - 2020/11/4

N2 - Multiple myeloma (MM) is associated with increased risk of infection, but little is known regarding antibody levels against specific bacteria. We assessed levels of polyclonal immunoglobulin and antibacterial antibodies in patients recruited to the TEAMM trial, a randomised trial of antibiotic prophylaxis at the start of anti-myeloma treatment. Polyclonal IgG, IgA and IgM levels were below the reference range in 71%, 83% and 90% of 838 MM patients at diagnosis. Anti-vaccine targeted tetanus toxoid antibodies were protective in 95% of 193 healthy controls but only 41% of myeloma patients. In healthy controls, protective antibodies against 6/12 pneumococcal serotypes, haemophilus and meningococcus A were present in 67%, 41% and 56% compared to just 15%, 21% and 17% of myeloma patients. By 1 year, myeloma patients IgG levels had recovered for 57% of patients whilst the proportion with protective levels of IgG against thymus-dependent protein antigen tetanus toxoid had changed little. In contrast the proportions of patients with protective levels against thymus independent polysaccharide antigens pneumococcus, haemophilus and meningococcus had fallen from 15 to 7%, 21 to 0% and 17 to 11%. Findings highlight the need for strategies to protect patients against bacterial infections during therapy and vaccination programmes during remission.

AB - Multiple myeloma (MM) is associated with increased risk of infection, but little is known regarding antibody levels against specific bacteria. We assessed levels of polyclonal immunoglobulin and antibacterial antibodies in patients recruited to the TEAMM trial, a randomised trial of antibiotic prophylaxis at the start of anti-myeloma treatment. Polyclonal IgG, IgA and IgM levels were below the reference range in 71%, 83% and 90% of 838 MM patients at diagnosis. Anti-vaccine targeted tetanus toxoid antibodies were protective in 95% of 193 healthy controls but only 41% of myeloma patients. In healthy controls, protective antibodies against 6/12 pneumococcal serotypes, haemophilus and meningococcus A were present in 67%, 41% and 56% compared to just 15%, 21% and 17% of myeloma patients. By 1 year, myeloma patients IgG levels had recovered for 57% of patients whilst the proportion with protective levels of IgG against thymus-dependent protein antigen tetanus toxoid had changed little. In contrast the proportions of patients with protective levels against thymus independent polysaccharide antigens pneumococcus, haemophilus and meningococcus had fallen from 15 to 7%, 21 to 0% and 17 to 11%. Findings highlight the need for strategies to protect patients against bacterial infections during therapy and vaccination programmes during remission.

U2 - 10.1038/s41408-020-00370-7

DO - 10.1038/s41408-020-00370-7

M3 - Article

C2 - 33149136

VL - 10

JO - Blood Cancer Journal

JF - Blood Cancer Journal

SN - 2044-5385

IS - 11

M1 - 114

ER -