Efficacy of single versus boost vaccination against influenza virus in patients with multiple myeloma

Hahn, Michael; Schnitzler, Paul; Schweiger, Brunhilde; Kunz, Christina; Ho, Anthony D.; Goldschmidt, Hartmut; Schmitt, Michael

doi:10.3324/haematol.2014.116772

Cited by 47 publications

(36 citation statements)

References 12 publications

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“…These data compare favorably with previous studies suggesting seroprotection rates less than 20% with a single standard vaccine 8 and up to 33% with two doses of standard vaccine 14 . Rates of seroconversion also significantly improved following both the initial dose to 39% and following the second dose to 55%.…”

Section: Discussionsupporting

confidence: 86%

Clinical and Serologic Responses After a Two-dose Series of High-dose Influenza Vaccine in Plasma Cell Disorders: A Prospective, Single-arm Trial

Branagan

Duffy

Albrecht

et al. 2017

Clinical Lymphoma Myeloma and Leukemia

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MicroAbstract The goal of the present study was to evaluate a novel prospective influenza vaccination strategy in patients with plasma cell disorders. Fifty-one patients were treated with a two dose series of high-dose inactivated trivalent influenza vaccine. This vaccination strategy was well tolerated led to very high rates of seroprotection against influenza. Background Patients with multiple myeloma (MM) and other plasma cell disorders are highly susceptible to influenza infections, which are major causes of morbidity in this population despite routine administration of seasonal influenza vaccination. Existing data are limited by small and retrospective studies, which suggest poor seroprotection rates of less than 20% following standard influenza vaccination in MM. Methods Patients with plasma cell dyscrasia (N=51) were treated with a two dose series of high-dose inactivated trivalent influenza vaccine over the 2014–2015 influenza season. Laboratory-confirmed influenza infections were identified through seasonal surveillance, sera were collected for influenza hemagglutination inhibition (HAI) titer assays, and logistic regression models were used to identify clinical correlates of HAI serologic responses. Findings Influenza vaccine was well tolerated without any vaccine-related ≥grade two adverse events. Only three patients (6%) experienced laboratory-confirmed influenza. Rates of HAI seroprotection against all three vaccine strains (influenza B, H1N1, and H3N2) increased from 4% at baseline to 49% and 65% following one and two doses, respectively. Risk factors associated with lower likelihood of HAI serologic response included plasma cell disorder requiring therapy, disease response assessment < partial response, or active conventional chemotherapy. Alternatively, active therapy with an immunomodulatory drug alone or with proteasome inhibitor was associated with a higher likelihood of HAI serologic response. Conclusions These data demonstrate that in contrast to historically poor results with standard influenza vaccination, this novel high-dose booster vaccination strategy leads to high rates of seroprotection. Randomized controlled studies are needed to compare this to standard vaccination strategy.

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Section: Discussionsupporting

confidence: 86%

Clinical and Serologic Responses After a Two-dose Series of High-dose Influenza Vaccine in Plasma Cell Disorders: A Prospective, Single-arm Trial

Branagan

Duffy

Albrecht

et al. 2017

Clinical Lymphoma Myeloma and Leukemia

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“…68 Some studies suggest monitoring antibody levels and to revaccinate if the antibody response is insufficient. 69 Ideally, patients should be vaccinated in the premalignant phase of the disease, specifically, when presenting with monoclonal gammopathy of undetermined significance or smoldering MM. Alternatively, vaccines should be given during optimal disease control.…”

Section: Vaccinationmentioning

confidence: 99%

How I manage the toxicities of myeloma drugs

Delforge

Ludwig

2017

Blood

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The treatment of multiple myeloma is considered a continuously evolving paradigm as a result of the growing availability of new and highly effective drugs, including first- and second-generation proteasome inhibitors, immunomodulatory agents, and monoclonal antibodies. Clinical trials advocate long-term rather than short-term treatment schedules with combinations of these new anti–myeloma drug classes. Although the overall toxicity profile of the recommended regimens can be considered favorable, their increasing complexity and prolonged use warrant a heightened vigilance for early and late side effects, a priori because real-life patients can be more frail or present with 1 or more comorbidities. The treatment decision process, at diagnosis and at relapse, therefore requires myeloma physicians to carefully balance efficacy and toxicity profiles for each individual patient. Early and/or unnecessary tapering or treatment discontinuation for drug-related adverse events may not only reduce patients’ quality of life, but also negatively impact their outcome. Accurate knowledge in recognizing and managing the potential side effects of present-day treatment regimens is therefore a cornerstone in myeloma care. Using 5 case vignettes, we discuss how to prevent and manage the most common nonhematological adverse events of anti–myeloma treatment regimens containing proteasome inhibitors, immunomodulatory drugs, and monoclonal antibodies.

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“…do kilkudziesięciu procent chorych na MM[25,26]. Szczepienia mogą być przeprowadzone u chorych leczonych lenalidomidem, który może zwiększać ich skuteczność[27].…”

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Szczepienia ochronne u dorosłych chorych na nowotwory hematologiczne oraz u chorych z asplenią – zalecenia PTHiT i sekcji do spraw zakażeń PALG

Hus

Piekarska

Roliński

et al. 2018

Acta Haematologica Polonica

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StreszczenieZakażenia należą do najczęstszych przyczyn chorobowości i śmiertelności chorych na nowotwory hematologiczne, a stosowanie szczepień ochronnych może w istotnym stopniu wpłynąć na zmniejszenie częstości ich występowania. W pracy przedstawiono przegląd danych dotyczących ryzyka zakażeń oraz skuteczności immunizacji czynnej u chorych na nowotwory hematologiczne i u pacjentów z anatomiczną lub czynnościową asplenią. Ponadto zawarto rekomendacje dla populacji polskich pacjentów opracowane przez Sekcję Zakażeń Polskiej Grupy ds. Leczenia Białaczek u Dorosłych (PALG) oraz Polskie Towarzystwo Hematologów i Transfuzjologów. Uwzględniono zarówno zalecenia ogólne dotyczące chorych na nowotwory, jak i szczegółowe odnoszące się do określonych nowotworów hematologicznych. Przedstawiono również propozycje poprawy organizacji szczepień u chorych na nowotwory hematologiczne w Polsce.

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Efficacy of single versus boost vaccination against influenza virus in patients with multiple myeloma

Cited by 47 publications

References 12 publications

Clinical and Serologic Responses After a Two-dose Series of High-dose Influenza Vaccine in Plasma Cell Disorders: A Prospective, Single-arm Trial

Clinical and Serologic Responses After a Two-dose Series of High-dose Influenza Vaccine in Plasma Cell Disorders: A Prospective, Single-arm Trial

How I manage the toxicities of myeloma drugs

Szczepienia ochronne u dorosłych chorych na nowotwory hematologiczne oraz u chorych z asplenią – zalecenia PTHiT i sekcji do spraw zakażeń PALG

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