the effectiveness of early vaccination with T-dependent vaccines in this category of patients with immunosuppression. Dendritic cells (DC1 and DC2) are restored in parallel by the 30th day from auto-HSCT (Kruskal-Wallis test 25.78; P <0.001 for DC-1 cells and Kruskal-Wallis test 11,17; P <0.025, respectively), what confirms the basis for the early vaccination with conjugated pneumococcal vaccines in this category of patients. Summary/Conclusion:The obtained data allows planning the introduction of the first dose of the conjugated pneumococcal vaccine 60 days after autologous HSCT, with the perspective of introducing an individualized vaccination calendar based on immunological parameters. It is also necessary to further implement immunization programs for immunocompromised patients, especially in hematology and cancer setting with the participation of a multidisciplinary team of specialists.

Methods: Clinical data of patients with MM who were transplanted in Penang General Hospital between 2008 to 2017 were collected retrospectively and analysed using SPSS IBM version 22.0. The patients were followed up from the time of transplant until 28 February 2018. The variables assesed included demographics, MM subtypes, remission status, induction chemotherapy pre-transplant and maintenance therapy post-transplant. Results: A total of 41 patients (18 males, 23 females) were evaluated. The median age at transplant was 54 years (ranged 33-65 years). There were 19 Malays (46.3%), 15 Chinese (36.6%) and 7 Indian patients (17.1%). 73% had IgG Kappa subtype. 41.5% presented with ISS II, 34.1% ISS III and 24.4% ISS I. 61% of patients were transplanted with at least a very good partial response (VGPR) compared with 39% with partial response (PR). Majority of patients (75%) received Bortezomib based induction therapy prior to transplant. 58% patients received maintenance treatment post-ASCT. The median follow-up was 35 months (range 3-103 months). The 5 years overall survival (OS) and progression-free survival (PFS) was 70% and 44.3% respectively. There was no transplant related mortality. Median PFS of patients with ISS III was only 11 months compared with 53 months for ISS I-II (p < 0.001). Patients who received maintenance had longer PFS (65 months versus 12 months, p = 0.032). Multivariate analysis revelaed ISS III as an independent risk factor for survival in our cohort (PFS hazard ratio (HR), 4.76;95% CI 1.81 to 12.49;p = 0.002). Other variables evaluated did not affect survival. Summary/Conclusion: ASCT improves survival in patients with multiple myeloma and is safe in patients below 65 years. ISS III is an independent risk factor of PFS.