{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:28:01Z","timestamp":1760059681926,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: This prospective study investigated the impact of high-dose chemotherapy and autologous stem cell transplantation (ASCT) on anti-COVID-19 antibody levels in previously vaccinated multiple myeloma (MM) patients with confirmed antibody response (AR). Methods: All patients underwent at least a two-dose regimen mRNA vaccination and later received a high-dose melphalan conditioning regimen and ASCT. Results: Fourteen MM patients with confirmed AR underwent a total of nineteen ASCT reinfusions; their median age was 55 (34\u201367). The study found a significant and progressive decrease in antibody levels after ASCT, from 311 BAU\/mL at baseline to 276 BAU\/mL and 188 BAU\/mL after one and three months, respectively, with a median anti-COVID-19 antibody level reduction of 39% (range 16\u201366%) that was statistically significant (p = 0.014) using the Friedman test. However, the third \u201cbooster\u201d vaccination post-ASCT improved the humoral response at six months in nine patients (50% response rate) and corrected, at least in part, the negative impact of high-dose chemotherapy (p = 0.597). Despite the antibody decline, three patients who contracted COVID-19 after ASCT experienced mild, outpatient-managed infections, suggesting sufficient immune response. Furthermore, booster doses increased the proportion of high-responders (AR &gt; 500 BAU\/mL) post-ASCT from 22% to 55% (5\/9 patients) at three and six months, respectively. Conclusions: The study concludes that ASCT negatively affects the humoral response, but booster vaccination can improve it, and residual antibodies may prevent severe COVID-19 in these vulnerable patients.<\/jats:p>","DOI":"10.3390\/jcm14134648","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T05:28:28Z","timestamp":1751347708000},"page":"4648","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["COVID-19 Vaccine Experience: Loss of Humoral Response Following Autologous Stem Cell Transplantation in Multiple Myeloma Patients and Positive Effect of Booster Dose"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0868-5676","authenticated-orcid":false,"given":"Uros","family":"Markovic","sequence":"first","affiliation":[{"name":"Hematology Unit with BMT A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, Via S. Sofia 78, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elvira","family":"Scalisi","sequence":"additional","affiliation":[{"name":"Hematology Unit with BMT A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, Via S. Sofia 78, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuliana","family":"Giunta","sequence":"additional","affiliation":[{"name":"Hematology Unit with BMT A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, Via S. Sofia 78, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Nardo","sequence":"additional","affiliation":[{"name":"Hematology Unit with BMT A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, Via S. Sofia 78, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9510-4755","authenticated-orcid":false,"given":"Andrea","family":"Duminuco","sequence":"additional","affiliation":[{"name":"Hematology Unit with BMT A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, Via S. Sofia 78, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nunziatina Laura","family":"Parrinello","sequence":"additional","affiliation":[{"name":"Hematology Unit with BMT A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, Via S. Sofia 78, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Marino","sequence":"additional","affiliation":[{"name":"Hematology Unit with BMT A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, Via S. Sofia 78, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria","family":"Iachelli","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa di Patologia Clinica PO Umberto I, Via Testaferrata 1, 99100 Siracusa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulio Antonio","family":"Milone","sequence":"additional","affiliation":[{"name":"Mediterranean Institute of Oncology, Via Penninazzo 7, 95029 Viagrande, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Scir\u00e8","sequence":"additional","affiliation":[{"name":"Mediterranean Institute of Oncology, Via Penninazzo 7, 95029 Viagrande, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriella","family":"Amato","sequence":"additional","affiliation":[{"name":"Mediterranean Institute of Oncology, Via Penninazzo 7, 95029 Viagrande, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Galbo","sequence":"additional","affiliation":[{"name":"Mediterranean Institute of Oncology, Via Penninazzo 7, 95029 Viagrande, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7840-4414","authenticated-orcid":false,"given":"Giuseppe","family":"Milone","sequence":"additional","affiliation":[{"name":"Hematology Unit with BMT A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, Via S. Sofia 78, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9760-887X","authenticated-orcid":false,"given":"Emanuele","family":"Martorana","sequence":"additional","affiliation":[{"name":"Mediterranean Institute of Oncology, Via Penninazzo 7, 95029 Viagrande, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6333-4433","authenticated-orcid":false,"given":"Alessandra","family":"Romano","sequence":"additional","affiliation":[{"name":"Hematology Unit with BMT A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, Via S. Sofia 78, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0862-3598","authenticated-orcid":false,"given":"Concetta","family":"Conticello","sequence":"additional","affiliation":[{"name":"Hematology Unit with BMT A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, Via S. Sofia 78, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Di Raimondo","sequence":"additional","affiliation":[{"name":"Hematology Unit with BMT A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, Via S. Sofia 78, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaetano","family":"Moschetti","sequence":"additional","affiliation":[{"name":"Mediterranean Institute of Oncology, Via Penninazzo 7, 95029 Viagrande, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Carc\u00f2","sequence":"additional","affiliation":[{"name":"Mediterranean Institute of Oncology, Via Penninazzo 7, 95029 Viagrande, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1056\/NEJMoa2034577","article-title":"Safety and Efficacy of the BNT162b2 mRNA COVID-19 Vaccine","volume":"383","author":"Polack","year":"2020","journal-title":"N. Engl. J. 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