COVID-19 Vaccine Efficacy in Patients with Multiple Myeloma and Waldenstrom Macroglobulinemia

Researchers at the Massachusetts General Hospital Cancer Center have investigated the effectiveness of COVID-19 vaccines in patients with multiple myeloma and Waldenstrom macroglobulinemia. The study found that patients with these conditions had impaired humoral responses to the primary vaccination series, but repeated booster vaccines significantly improved immunogenicity. The study's findings have important implications for the vaccination strategies of patients with these conditions.

Key Takeaways:

• Patients with multiple myeloma and Waldenstrom macroglobulinemia have increased risk of severe COVID-19 due to impaired humoral responses to the primary vaccination series.
• The effective immune response (EIR) rate after the primary vaccination series was 47% and 25% in patients with multiple myeloma and Waldenstrom macroglobulinemia, respectively.
• After the first and second booster vaccinations, the EIR rates increased to 84% and 91% in patients with multiple myeloma and 60% and 89% in those with Waldenstrom macroglobulinemia, respectively.
• Factors associated with lower EIR in patients with multiple myeloma included hypogammaglobulinemia, lymphopenia, and treatment with anti-CD38 monoclonal antibody or corticosteroid.
• In patients with Waldenstrom macroglobulinemia, treatment with a Bruton tyrosine kinase inhibitor or rituximab was associated with a lower EIR, whereas asymptomatic and treatment-naive patients had a higher EIR.
• Functional profiling identified reduced antibody-dependent cellular phagocytosis, neutrophil phagocytosis, and natural killer cell activity against wild-type and variant SARS-CoV-2 in patients with multiple myeloma and Waldenstrom macroglobulinemia compared to healthy donors.
• Repeated booster vaccines significantly improve immunogenicity in patients with multiple myeloma and Waldenstrom macroglobulinemia.

Statistics:

• 93 patients with multiple myeloma and 48 patients with Waldenstrom macroglobulinemia participated in the study.
• The study found that 47% of patients with multiple myeloma and 25% of those with Waldenstrom macroglobulinemia had an effective immune response after the primary vaccination series.
• The EIR rates increased to 84% and 91% in patients with multiple myeloma and 60% and 89% in those with Waldenstrom macroglobulinemia after the first and second booster vaccinations, respectively.

Sources:

• NewsRx. New Data from Massachusetts General Hospital Cancer Center Illuminate Research in COVID-19 (Prospective study of immunogenicity to SARS-CoV-2 booster vaccines in multiple myeloma and Waldenstrom macroglobulinemia). Medical Letter on the CDC & FDA. September 28, 2025; p 287.
• Prospective study of immunogenicity to SARS-CoV-2 booster vaccines in multiple myeloma and Waldenstrom macroglobulinemia. Blood Advances, 2025, 9(18): 4568-4579. The publisher for Blood Advances is Elsevier.