1
|
Twumasi C, Moore S, Sadler R, Jeans S, Varghese S, Turner A, Agarwal G, Larham J, Gray N, Carty O, Barrett J, Bowcock S, Oppermann U, Gamble V, Cook G, Kyriakou C, Drayson M, Basu S, McDonald S, McKinley S, Gooding S, Javaid MK, Ramasamy K. Determinants of durable humoral and T cell immunity in myeloma patients following COVID-19 vaccination. Eur J Haematol 2024; 112:547-553. [PMID: 38116695 DOI: 10.1111/ejh.14143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
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.
Collapse
Affiliation(s)
- Clement Twumasi
- School of Public Health, Imperial College London, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sally Moore
- Bath Royal United Hospitals, Oxford University Hospitals NHS Trust, Bath, UK
| | - Ross Sadler
- Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK
| | | | - Sherin Varghese
- Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Alison Turner
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Gaurav Agarwal
- Medical Sciences Division, University of Oxford, Oxford, UK
| | - Jemma Larham
- Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Nathanael Gray
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Oluremi Carty
- Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Joe Barrett
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Stella Bowcock
- Department of Haematology, King's College Hospital NHS Trust, London, UK
| | - Udo Oppermann
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Vicky Gamble
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Gordon Cook
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Chara Kyriakou
- Department of Haematology, University College London Hospitals NHS Trust, London, UK
| | - Mark Drayson
- Division of Immunity and Infection, University of Birmingham, Birmingham, UK
| | - Supratik Basu
- Department of Haematology, University of Wolverhampton, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | | | | | - Sarah Gooding
- Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK
- MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Muhammad K Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Karthik Ramasamy
- Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK
- Radcliffe Department of Medicine, Oxford University, Oxford, UK
| |
Collapse
|
2
|
Kadra-Scalzo G, Ahn D, Bird A, Broadbent M, Chang CK, Pritchard M, Shetty H, Taylor D, Hayes R, Stewart R. Mental healthcare utilisation by patients before and after receiving paliperidone palmitate treatment: mirror image analyses. BMJ Open 2022; 12:e051567. [PMID: 35387806 PMCID: PMC8987753 DOI: 10.1136/bmjopen-2021-051567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To compare mental healthcare use and healthcare professional (HCP) contacts for patients before and after initiation of paliperidone palmitate. SETTING The South London and Maudsley NHS Foundation Trust (SLAM) Biomedical Research Centre Clinical Record Interactive Search. PARTICIPANTS We identified all adults with a diagnosis of schizophrenia (International Classification of Diseases 10th Revision: F20.x), who had received paliperidone palmitate prescription for at least 365 days and had at least 1 year of recorded treatment from SLAM, prior to the first recorded receipt of paliperidone palmitate. PRIMARY AND SECONDARY OUTCOME MEASURES Inpatient and community mental healthcare service use, such as inpatient bed days, number of active days in the service, face-to-face and telephone HCP use in the 12 months before and after paliperidone palmitate initiation. RESULTS We identified 664 patients initiated on paliperidone palmitate. Following initiation, inpatient bed days were lower, although patients remained active on the service case load longer for both mirror approach 1 (mean difference of inpatient bed days -10.48 (95% CI -15.75 to -5.22); days active 40.67 (95% CI 33.39 to 47.95)) and mirror approach 2 (mean difference of inpatient bed days -23.96 (95% CI -30.01 to -17.92); mean difference of days active 40.69 (95% CI 33.39 to 47.94)). The postinitiation period was further characterised by fewer face-to-face and telephone contacts with medical and social work HCPs, and an increased contact with clinical psychologists. CONCLUSIONS Our findings indicate a change in the profile of HCP use, consistent with a transition from treatment to possible rehabilitation.
Collapse
Affiliation(s)
| | - Deborah Ahn
- Psychological Medicine, King's College London, London, UK
| | - Alex Bird
- Janssen Pharmaceutical Companies of Johnson & Johnson, Titusville, New Jersey, USA
| | - Matthew Broadbent
- South London and Maudsley NHS Foundation Trust. London, UK, London, UK
| | - Chin-Kuo Chang
- Psychological Medicine, King's College London, London, UK
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Megan Pritchard
- South London and Maudsley NHS Foundation Trust. London, UK, London, UK
| | - Hitesh Shetty
- South London and Maudsley NHS Foundation Trust. London, UK, London, UK
| | - David Taylor
- South London and Maudsley NHS Foundation Trust. London, UK, London, UK
| | - Richard Hayes
- Psychological Medicine, King's College London, London, UK
| | - Robert Stewart
- Psychological Medicine, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust. London, UK, London, UK
| |
Collapse
|