Event Abstract Back to Event Defining antibody responses in normal and non-malignant human aging populations Sarah M. Tete1, Kasper Wilting2, Gerda Horst1, Michiel Klijn3, Johanna Westra1, Aalzen De Haan4, Anke Huckriede4, Hanneke Kluin-Nelemans5, Surinder Sahota6, Marc Bijl7 and Nico Bos1* 1 University Medical Centre Groningen, Reumatology and Clinical Immunology, Netherlands 2 University Medical Centre Groningen, Department of Medical Microbiology, Netherlands 3 General Practitioners Practice, Huisarten Boterdiep, Netherlands 4 University Medical Centre Groningen, Department of Medical Microbiology, Molecular Virology section, Netherlands 5 University Medical Centre Groningen, Department of Hematology, Netherlands 6 University of Southampton, Cancer Sciences Division, School of Medicine, United Kingdom 7 Martini Ziekenhuis, Department of Internal Medicine and Rheumatology, Netherlands Understanding immunosenescence in ageing is a pressing need to counter the increased susceptibility to infections, as apparent in the inadequate response to influenza virus that underlies>90% of deaths associated with infection in the elderly. The emergence of non-malignant conditions like Monoclonal Gammopathy of Undetermined Significance (MGUS) in the elderly may further alter this susceptibility, and remain poorly defined. To investigate this, we examined linked B- and T-cell responses to influenza vaccination in a healthy elderly cohort (n=19) and contrasted these with aged individuals with MGUS (n=19), a benign plasma cell monoclonal expansion in the bone marrow that secretes elevated levels of monoclonal protein. Influenza H1N1- and H3N2-specific IgG levels were measured and the frequencies of H1N1- and H3N2-specific IFN-γ-secreting cells assayed by enzyme-linked immunospot. Comparable influenza-specific IgG titers were seen in HCs and MGUS at a cohort level, and MGUS patients showed a significant increase in influenza-specific IgG responses post-vaccination. However, significant differences emerged in MGUS in relation to M-protein levels. MGUS with low M-protein showed increased influenza-specific IgG titers post-vaccination but MGUS with high M-protein had lower influenza-specific IgG titers which they failed to expand post-vaccination. Contrary to HCs, MGUS patients revealed impaired T-cell responses, as the number of IFN-γ-secreting cells didnot increase post-vaccination. M-protein concentration inversely correlated with influenza-specific IgG response at d7 (p=0.020) and d28 (p=0.012) as well as with the number of IFN-γ-secreting cells (p=0.018) at d28 post-vaccination. MGUS, as a non-malignant clonal expansion, depresses immune responses to influenza vaccination that varies strikingly with M-protein levels.