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Research Article
Ivana von Metzler
Hospital of the Goethe University Frankfurt: Klinikum der Johann Wolfgang Goethe-Universitat Frankfurt
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1699-4313
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Multiple myeloma patients are often treated with immunomodulatory drugs, proteasome inhibitors or monoclonal antibodies until disease progression. Chronic therapy in combination with the underlying disease frequently results in severe humoral and cellular immunodeficiency, which often manifests in recurrent infections. Here we report on the clinical management and immunological data of one multiple myeloma patient diagnosed with COVID-19. Despite severe hypogammaglobulinemia, deteriorated T cell counts and neutropenia, the patient unexpectedly combated COVID-19 by balanced response of innate immunity, strong CD8+ and CD4+ T cell activation and differentiation, development of specific T-cell memory subsets, as well as development of anti-SARS-CoV-2 type IgA and IgG antibodies. Even 6 months after re-introduction of lenalidomide maintenance therapy, specific T cell response and antibody levels remained detectable, indicating persisting immunity against SARS-CoV-2. We conclude that in MM patients who tested positive for SARS-CoV-2 and were receiving active MM treatment, immune response assessment could be a useful tool to help guide decision-making regarding the continuation of anti-tumor therapy and supportive therapy.
Keywords
multiple myeloma, SARS-CoV-2, COVID-19, immune response
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CURRENT STATUS: Under Review
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Posted 25 Mar, 2021
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Editorial decision: Major Revisions Needed
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This preprint is under consideration at Journal of Molecular Medicine. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Ivana von Metzler
Hospital of the Goethe University Frankfurt: Klinikum der Johann Wolfgang Goethe-Universitat Frankfurt
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1699-4313
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 25 Mar, 2021
No community comments so far
Editorial decision: Major Revisions Needed
On 07 Apr, 2021
Reviewers invited
Invitations sent on 22 Mar, 2021
Reviews received
Received 22 Mar, 2021
Editor assigned
On 16 Mar, 2021
First submitted
On 08 Mar, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Multiple myeloma patients are often treated with immunomodulatory drugs, proteasome inhibitors or monoclonal antibodies until disease progression. Chronic therapy in combination with the underlying disease frequently results in severe humoral and cellular immunodeficiency, which often manifests in recurrent infections. Here we report on the clinical management and immunological data of one multiple myeloma patient diagnosed with COVID-19. Despite severe hypogammaglobulinemia, deteriorated T cell counts and neutropenia, the patient unexpectedly combated COVID-19 by balanced response of innate immunity, strong CD8+ and CD4+ T cell activation and differentiation, development of specific T-cell memory subsets, as well as development of anti-SARS-CoV-2 type IgA and IgG antibodies. Even 6 months after re-introduction of lenalidomide maintenance therapy, specific T cell response and antibody levels remained detectable, indicating persisting immunity against SARS-CoV-2. We conclude that in MM patients who tested positive for SARS-CoV-2 and were receiving active MM treatment, immune response assessment could be a useful tool to help guide decision-making regarding the continuation of anti-tumor therapy and supportive therapy.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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