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Clinical and Developmental Immunology
Volume 2012, Article ID 134081, 9 pages
Clinical Study

Longitudinal Analysis of Tetanus- and Influenza-Specific IgG Antibodies in Myeloma Patients

1Department of Internal Medicine II, and Department of Oncology, Hematology, Bone Marrow Transplantation Section of Pneumology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
2Hubertus Wald Tumorzentrum, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
3Division of Clinical Pharmacology, Department of Internal Medicine, Ludwig-Maximilian University, 80336 Munich, Germany
4Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
5Institute for Immunology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany

Received 8 November 2011; Revised 25 December 2011; Accepted 28 December 2011

Academic Editor: Mohamad Mohty

Copyright © 2012 Sebastian Kobold et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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 ( ). Immunoreactivity decreased with progressing disease and worsening clinical status. Levels of FLU- and TT-specific antibodies increased shortly (0-6 months) after alloSCT ( ), 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.