Official websites use. Share sensitive information only on official, secure websites. Vaccination is one of the most successful medical interventions that has saved the life of millions of people. Vaccination is particularly important in patients with multiple myeloma, who have an increased risk of infections due to the disease-inherent immune suppression, and because of the immune suppressive effects of therapy.
Hence, all appropriate measures should be exploited, to elicit an effective immune response to common pathogens like influenza, pneumococci, varicella zoster virus, and to those bacteria and viruses haemophilus influenzae, meningococci, and hepatitis that frequently may pose a significant risk to patients with multiple myeloma.
Patients after autologous, and specifically after allogeneic transplantation have severely reduced antibody titers, and therefore require a broader spectrum of vaccinations.
Here, we compile the existing data on vaccination in multiple myeloma and provide recommendations for clinical practice. Infections remain the most common cause of morbidity and mortality in multiple myeloma besides the disease itself [ 1 , 2 ]. The risk of infection is increased already at the stage of MGUS [ 3 ], and is even higher in patients with active disease when starting anti-myeloma therapy. One population-based study has estimated a tenfold higher risk for viral and a sevenfold higher risk for bacterial infections in multiple myeloma [ 4 ].
Severe humoral and cellular immune suppression, particularly during episodes of uncontrolled disease, account mainly for the increased susceptibility for infections. This predisposition is aggravated by the negative consequences of anti-myeloma therapy associated with severe immune suppression including impaired T-cell function and antibody production.
