Chuleerarux N.Manothummetha K.Moonla C.Sanguankeo A.Kates O.S.Hirankarn N.Phongkhun K.Thanakitcharu J.Leksuwankun S.Meejun T.Thongkam A.Mongkolkaew T.Dioverti M.V.Torvorapanit P.Langsiri N.Worasilchai N.Plongla R.Chindamporn A.Gopinath S.Nissaisorakarn P.Thaniyavarn T.Nematollahi S.Permpalung N.Mahidol University2023-06-202023-06-202022-12-27Blood Advances Vol.6 No.24 (2022) , 6198-620724739529https://repository.li.mahidol.ac.th/handle/20.500.14594/87148Patients with multiple myeloma (MM) have a diminished immune response to coronavirus disease 2019 (COVID-19) vaccines. Risk factors for an impaired immune response are yet to be determined. We aimed to summarize the COVID-19 vaccine immunogenicity and to identify factors that influence the humoral immune response in patients with MM. Two reviewers independently conducted a literature search in MEDLINE, Embase, ISI Web of Science, Cochrane library, and Clinicaltrials.gov from existence until 24 May 24 2022. (PROSPERO: CRD42021277005). A total of 15 studies were included in the systematic review and 5 were included in the meta-analysis. The average rate (range) of positive functional T-lymphocyte response was 44.2% (34.2%-48.5%) after 2 doses of messenger RNA (mRNA) COVID-19 vaccines. The average antispike antibody response rates (range) were 42.7% (20.8%-88.5%) and 78.2% (55.8%-94.2%) after 1 and 2 doses of mRNA COVID-19 vaccines, respectively. The average neutralizing antibody response rates (range) were 25% (1 study) and 62.7% (53.3%-68.6%) after 1 and 2 doses of mRNA COVID-19 vaccines, respectively. Patients with high-risk cytogenetics or receiving anti-CD38 therapy were less likely to have a humoral immune response with pooled odds ratios of 0.36 (95% confidence interval [95% CI], 0.18, 0.69), I2 = 0% and 0.42 (95% CI, 0.22, 0.79), I2 = 14%, respectively. Patients who were not on active MM treatment were more likely to respond with pooled odds ratio of 2.42 (95% CI, 1.10, 5.33), I2 = 7%. Patients with MM had low rates of humoral and cellular immune responses to the mRNA COVID-19 vaccines. Further studies are needed to determine the optimal doses of vaccines and evaluate the use of monoclonal antibodies for pre-exposure prophylaxis in this population.MedicineReviewSCOPUS10.1182/bloodadvances.20220085302-s2.0-851475870832473953736538342