The risk of infections in multiple myeloma before and after the advent of novel agents: a 12-year survey

Brioli, Annamaria; Klaus, Maximilian; Sayer, Herbert G.; Scholl, Sebastian; Ernst, Thomas; Hilgendorf, Inken; Scherag, André; Yomade, Olaposi; Schilling, K; Hochhaus, Andreas; Mügge, Lars-Olof; Lilienfeld‐Toal, Marie von

doi:10.1007/s00277-019-03621-1

Cited by 42 publications

(41 citation statements)

References 22 publications

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“…Patients treated with proteasome inhibitors [2], daratumumab [34], high-dose melphalan followed by autologous stem cell transplantation (ASCT) [2], and high doses of glucocorticosteroids [2] have a higher risk for varicella zoster virus (VZV) reactivation. Reactivation of latent virus residing in sensory ganglions leads to active virus production, spread alongside the axons down to the area of skin innervated by that ganglion, inflammation, blisters, and pain [35].…”

Section: Varicella Zostermentioning

confidence: 99%

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Recommendations for vaccination in multiple myeloma: a consensus of the European Myeloma Network

Ludwig¹,

Boccadoro

Moreau

et al. 2020

Leukemia

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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 diseaseinherent 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. Response to vaccination in myeloma often is less vigorous than in the general population, mandating either measurement of the postvaccination antibody titers and/or repeating the vaccination. Here, we compile the existing data on vaccination in multiple myeloma and provide recommendations for clinical practice.

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Section: Varicella Zostermentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

Recommendations for vaccination in multiple myeloma: a consensus of the European Myeloma Network

Ludwig¹,

Boccadoro

Moreau

et al. 2020

Leukemia

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“…Proteasome inhibitors, especially bortezomib, have been shown to increase the risk of reactivation of varicella zoster viruses (VZV) in patients not receiving prophylactic anti-viral agents [82]. Reactivation usually occurs late during treatment [83]. Herpes zoster infection has been shown to be the most common cutaneous comorbidity in MM patients [84].…”

Section: Herpetic and Post-herpetic Neuralgiamentioning

confidence: 99%

Pain Management in Patients with Multiple Myeloma: An Update

Coluzzi

Rolke

Mercadante

2019

Cancers

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Most patients with multiple myeloma (MM) suffer from chronic pain at every stage of the natural disease process. This review focuses on the most common causes of chronic pain in MM patients: (1) pain from myeloma bone disease (MBD); (2) chemotherapy-induced peripheral neuropathy as a possible consequence of proteasome inhibitor therapy (i.e., bortezomib-induced); (3) post-herpetic neuralgia as a possible complication of varicella zoster virus reactivation because of post-transplantation immunodepression; and (4) pain in cancer survivors, with increasing numbers due to the success of antiblastic treatments, which have significantly improved overall survival and quality of life. In this review, non-pain specialists will find an overview including a detailed description of physiopathological mechanisms underlying central sensitization and pain chronification in bone pain, the rationale for the correct use of analgesics and invasive techniques in different pain syndromes, and the most recent recommendations published on these topics. The ultimate target of this review was to underlie that different types of pain can be observed in MM patients, and highlight that only after an accurate pain assessment, clinical examination, and pain classification, can pain be safely and effectively addressed by selecting the right analgesic option for the right patient.

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“…1a, b. Generally, patients with controlled underlying disease have fewer infections than untreated patients [21], therefore, uncontrolled malignant disease should be avoided and lifethreatening malignancy needs treatment, especially if there is relevant curative potential. As stated above, impairments and shortages due to the emergency situation need to be taken into account.…”

Section: Specific Aspects For Hematologists and Oncologistsmentioning

confidence: 99%

Frequently asked questions regarding SARS-CoV-2 in cancer patients—recommendations for clinicians caring for patients with malignant diseases

et al. 2020

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Since early 2020, the SARS-CoV-2 pandemic has a massive impact on health care systems worldwide. Patients with malignant diseases are assumed to be at increased risk for a worse outcome of SARS-CoV-2 infection, and therefore, guidance regarding prevention and management of the infection as well as safe administration of cancer-therapy is required. Here, we provide recommendations for the management of patients with malignant disease in the times of COVID-19. These recommendations were prepared by an international panel of experts and then consented by the EHA Scientific Working Group on Infection in Hematology. The primary aim is to enable clinicians to provide optimal cancer care as safely as possible, since the most important protection for patients with malignant disease is the best-possible control of the underlying disease.

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The risk of infections in multiple myeloma before and after the advent of novel agents: a 12-year survey

Cited by 42 publications

References 22 publications

Recommendations for vaccination in multiple myeloma: a consensus of the European Myeloma Network

Recommendations for vaccination in multiple myeloma: a consensus of the European Myeloma Network

Pain Management in Patients with Multiple Myeloma: An Update

Frequently asked questions regarding SARS-CoV-2 in cancer patients—recommendations for clinicians caring for patients with malignant diseases

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