title: Longitudinal analysis of tetanus- and influenza-specific IgG antibodies in myeloma patients.
abstract: BACKGROUND
  Multiple myeloma (MM) and its therapies may induce a severely compromised humoral immunity. We have performed a longitudinal analysis of IgG-antibody responses against influenza virus (FLU) and tetanus toxoid (TT) as surrogate markers for the B cell-mediated immunity in MM patients.
  
  
  METHODS
  1094 serum samples of 190 MM patients and samples from 100 healthy donors were analyzed by ELISA for FLU- and TT-specific antibodies.
  
  
  RESULTS
  MM patients evidenced lower levels of FLU- and TT-specific antibodies than healthy controls (P < 0.001). Immunoreactivity decreased with progressing disease and worsening clinical status. Levels of FLU- and TT-specific antibodies increased shortly (0-6 months) after alloSCT (P < 0.001), a time-period during which intravenous immunoglobulin (IVIG) is routinely applied. Thereafter, antibody concentrations declined and remained suppressed for 3 years in the case of FLU-specific and for more than 5 years in the case of TT-specific antibodies.
  
  
  CONCLUSIONS
  We found that MM is associated with a profound disease- and therapy-related immunosuppression, which is compensated for a few months after alloSCT, most likely by application of IVIG. This and the differences regarding the recovery of anti-FLU and anti-TT antibody titers during the following years need to be taken into account for optimizing IVIG application and immunization after alloSCT.
authors.affiliation: Department of Internal Medicine II, and Department of Oncology, Hematology, Bone Marrow Transplantation Section of Pneumology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kobold
authors.forename: Tim
authors.initials: T
authors.lastname: Luetkens
authors.forename: Britta Marlen
authors.initials: BM
authors.lastname: Bartels
authors.forename: Yanran
authors.initials: Y
authors.lastname: Cao
authors.forename: York
authors.initials: Y
authors.lastname: Hildebrandt
authors.forename: Orhan
authors.initials: O
authors.lastname: Sezer
authors.forename: Henrike
authors.initials: H
authors.lastname: Reinhard
authors.forename: Julia
authors.initials: J
authors.lastname: Templin
authors.forename: Katrin
authors.initials: K
authors.lastname: Bartels
authors.forename: Nesrine
authors.initials: N
authors.lastname: Lajmi
authors.forename: Friedrich
authors.initials: F
authors.lastname: Haag
authors.forename: Carsten
authors.initials: C
authors.lastname: Bokemeyer
authors.forename: Nicolaus
authors.initials: N
authors.lastname: Kröger
authors.forename: Djordje
authors.initials: D
authors.lastname: Atanackovic
mesh_terms: D000368:Aged; D000907:Antibodies, Bacterial / Q000096:biosynthesis* / Q000276:immunology; D000914:Antibodies, Viral / Q000096:biosynthesis* / Q000276:immunology; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000276:immunology*; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D056724:Immunity, Humoral; D007074:Immunoglobulin G / Q000097:blood* / Q000276:immunology; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007165:Immunosuppression Therapy; D029521:Alphainfluenzavirus / Q000276:immunology*; D007275:Injections, Intravenous; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology* / Q000628:therapy; D019590:Nucleocapsid Proteins; D016601:RNA-Binding Proteins / Q000276:immunology; D033581:Stem Cell Transplantation; D013745:Tetanus Toxoid / Q000276:immunology*; D014184:Transplantation, Homologous; D014758:Viral Core Proteins / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D000970:Antineoplastic Agents; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; C048842:NP protein, Influenza A virus; D019590:Nucleocapsid Proteins; D016601:RNA-Binding Proteins; D013745:Tetanus Toxoid; D014758:Viral Core Proteins