Clinical efficacy of pneumococcal vaccination in multiple myeloma patients on novel agents: Results of a prospective clinical study

Stoma, Igor; Karpov, Igor; Искров, И. А.; Лендина, И. Ю.; Uss, Anatoly

doi:10.1016/j.vaccine.2020.05.024

Cited by 9 publications

(4 citation statements)

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“…Although response to immunizations is frequently impaired in patients with MM, pneumococcal vaccines are effective in reducing the risk of pneumonia; therefore, routine vaccination against Streptococcus pneumoniae and Haemophilus influenzae is recommended. 16,30,31 Blimark et al 4 found that viral infections were ten times higher in patients with MM compared with matched controls. The APEX study described an increased incidence of VZV reactivation in bortezomib-treated patients.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology and Risk Factors for the Development of Infectious Complications in Newly Diagnosed Multiple Myeloma: A Multicenter Prospective Cohort Study in Latin America

Bove

Riva

Vásquez

et al. 2022

JCO Global Oncology

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PURPOSE Infections are a significant cause of morbidity and mortality in patients with multiple myeloma (MM). In Latin America, data on infectious complications in this patient population are lacking. METHODS We conducted a prospective cohort study of patients with newly diagnosed MM (NDMM) in seven Latin American countries between June 2019 and May 2020. Patients with active disease, on active therapy, and with a follow-up of 6 months from the time of diagnosis were included. Our primary end point was the number of infectious events that required hospitalization for ≥ 24 hours. RESULTS Of 248 patients with NDMM, 89 (35.9%) had infectious complications (113 infectious events), the majority (67.3%) within the first 3 months from diagnosis. The most common sites of infection were respiratory (38%) and urinary tract (31%). The microbial agent was identified in 57.5% of patients with gram-negative bacteria (73.5%) as the most common pathogen. Viral infections were infrequent, and no patients with fungal infection were reported. In the multivariable analysis, diabetes mellitus (odds ratio [OR], 2.71; 95% CI, 1.23 to 6.00; P = .014), creatinine ≥ 2 mg/dL (OR, 4.87; 95% CI, 2.29 to 10.35; P < .001), no use of trimethoprim-sulfamethoxazole prophylaxis (OR, 6.66; 95% CI, 3.43 to 12.92; P < .001), and treatment with immunomodulatory drugs (OR, 3.02; 95% CI, 1.24 to 6.29; P = .003) were independent factors associated with bacterial infections. At 6 months, 21 patients (8.5%) had died, 47.6% related to infectious complications. CONCLUSION Bacterial infections are a substantial cause of hospital admissions and early death in patients with NDMM. Antibiotic prophylaxis should be considered to reduce infectious complications in patients with MM.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Epidemiology and Risk Factors for the Development of Infectious Complications in Newly Diagnosed Multiple Myeloma: A Multicenter Prospective Cohort Study in Latin America

Bove

Riva

Vásquez

et al. 2022

JCO Global Oncology

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“…Несмотря на то, что уже имеются данные относительно профилей безопасности таргетной и иммунотерапии с точки зрения инфекционных рисков [36], до настоящего времени отсутствовало полное понимание клинической эффективности пневмококковой вакцинации у пациентов с множественной миеломой, получающих лечение новыми агентами и таргетными лекарственными средствами, в частности, ингибиторами протеасом (иксазомиб, бортезомиб) и иммуномодулирующими препаратами (леналидомид, талидомид, помалидомид). В связи с этим целью недавно опубликованного исследования была оценка клинической эффективности новой предложенной трёхдозовой схемы вакцинации 13-валентной пневмококковой конъюгированной вакциной (PCV13) в отношении профилактики пневмоний у пациентов с множественной миеломой на фоне лечения новыми агентами [37]. В данном проспективном клиническом исследовании вакцинация производилась 13-валентной пневмококковой вакциной (PCV13) в соответствии с инструкцией по применению в интервалах между блоками лечения новыми агентами (бортезомиб, леналидомид, иксазомиб в сочетании или без дексаметазона).…”

Section: обзор Reviewunclassified

“…И, действительно, в недавнем исследовании с участием пожилых людей (пациенты старше 70 лет) вакцинация удвоенной дозой PCV вызвала более выраженный иммунный ответ в сравнении с вакцинацией одной дозой [49]. Такая стратегия может быть эффективна для достижения адекватной защиты от пневмококковой инфекции коньюгированной вакциной как у пациентов с вялотекущей ММ, так и у пациентов с другими формами ММ на фоне терапии новыми агентами, что и было доказано недавно опубликованными результатами клинических исследований [37]. Кроме того, у некоторых групп пациентов с иммуносупрессией рекомендовано введение PPV23 (полисахаридной 23-валентной пневмококковой вакцины) по крайней мере через два месяца после вакцинации коньюгированной Обзор Review пневмококковой вакциной.…”

Section: обзор Reviewunclassified

Clinical and Immunological Aspects of Pneumococcal Vaccination in Patients with Multiple Myeloma

Stoma

2021

Epidemiology and Vaccinal Prevention

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Relevance. Among the groups at high risk of developing invasive pneumococcal infections, patients with multiple myeloma (MM) stand out among the highest rates of morbidity and mortality due to the presence of profound immunosuppression. Aims: to outline the current state of the problem of vaccine prevention of pneumococcal infection in patients receiving treatment for multiple myeloma, to present the evidence base for vaccination with conjugated pneumococcal vaccine. A continuous data review method was used to evaluate the studies on vaccination approaches against pneumococcal infection in patients with multiple myeloma. Conclusions. The article presents modern epidemiological data, as well as the results of original studies of clinical and immunological aspects of pneumococcal vaccination in patients with MM receiving new targeted agents and immunotherapy. The effectiveness of the use of the conjugated pneumococcal vaccine in patients treated with MM with bortezomib, lenalidomide, and ixazomib was indicated. An independent protective effect of pneumococcal vaccination has been shown as a preventive measure in a cohort of patients with MM, against the background of treatment with new targeted drugs.

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Safety and Efficacy of Vaccines in Patients on Targeted and Biologic Therapies

Sonpar

2022

Infectious Complications in Biologic and Targeted Therapies

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Clinical efficacy of pneumococcal vaccination in multiple myeloma patients on novel agents: Results of a prospective clinical study

Cited by 9 publications

References 9 publications

Epidemiology and Risk Factors for the Development of Infectious Complications in Newly Diagnosed Multiple Myeloma: A Multicenter Prospective Cohort Study in Latin America

Epidemiology and Risk Factors for the Development of Infectious Complications in Newly Diagnosed Multiple Myeloma: A Multicenter Prospective Cohort Study in Latin America

Clinical and Immunological Aspects of Pneumococcal Vaccination in Patients with Multiple Myeloma

Safety and Efficacy of Vaccines in Patients on Targeted and Biologic Therapies

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