A COVID update with Dr. Sundar Jagganath, Mount Sinai and Cynthia Chmielewski, HealthTree University Director
New York City was an early a hotbed for COVID and Sundar Jagganath, MD of Mount Sinai was in the thick of things. With a dense population and a large number of multiple myeloma patients, Mount Sinai performed extensive testing using PCR and other types of tests to develop an extensive set of data of myeloma patient outcomes. The team published on their data with a major presentation at ASH 2021.
They found that many patients can develop decent levels of COVID antibodies, but not all patients make antibodies. Patients who are not likely to develop COVID antibodies include patients taking daratumumab, patients on bispecific antibodies and patients receiving CAR T. These patients typically don't mount antibodies after the first two vaccinations but 70% of patients who get the third booster did develop antibodies.
What about a fourth dose of a COVID vaccine? Dr. Jagganath says you might need it! He suggests getting the fourth booster because your COVID antibody levels can decrease over time, even for healthy individuals.
Dr. Jagganath suggests that you test regularly to watch and track your COVID antibody levels. He suggests that doctors follow this as carefully as if the patient was on a clinical trial. For patients who are on treatment, this is especially important. He noted that daratumumab's main function is to eliminate plasma cells and plasma cells make antibodies, so if you are removing plasma cells with dara or with CAR T or bispecifics, you will always have fewer antibodies.
Dr. Jagganath's experience with the Omicron variant is that patients are getting it but can usually get over it just fine. He is only concerned about patients who never developed antibodies. Healthy people who have high antibody levels and have been exposed to the Omicron variant are not necessarily getting sick, even when they test positive. Dr. Jagganath suggests that for the coming month to wear your mask, limit your visitations and hold on for what could be the final stretch. He gives us hope that COVID immunity will go up because of Omicron and better treatments for active COVID cases are making things better overall.
about the author
Myeloma survivor, patient advocate, wife, mom of 6. Believer that patients can help accelerate a cure by weighing in and participating in clinical research. Founder of HealthTree Foundation (formerly Myeloma Crowd).