Immunogenicity of vaccination against influenza, Streptococcus pneumoniae and Haemophilus influenzae type B in patients with multiple myeloma

Abstract

Vaccination against influenza and Streptococcus pneumoniae is recommended for elderly and immunocompromised individuals. However, there is little information concerning the efficacy of vaccination in specific groups of patients. In this study, 52 patients underwent vaccination against influenza, S. pneumoniae and Haemophilus influenzae type b (Hib) as they attended hospital outpatient clinics. Serum was analysed prior to vaccination and 4–6 weeks afterwards. Antibody titres against S. pneumoniae and Hib were compared with reference values corresponding to the geometric mean titres of a healthy UK population. For influenza vaccination, haemagglutination inhibition (HI) titres were measured against three inactivated strains; a titre of ≥ 1/40 was considered protective. No patient had protective titres to all three antigens prior to vaccination and 41 patients (85%) had titres < 1/40 to all 3 strains. Post vaccination only 9/48 patients (19%) achieved protective antibody titres. Resistance to S. pneumoniae and response to Pneumovax II was also poor: prevaccination, 45 patients (93%) had suboptimal antibody titres and in 26/43 patients (61%) titres remained low post vaccination. Resistance to Hib and response to vaccination was comparable with the healthy adult UK population. These results question the practice of routine influenza and pneumococcal vaccination in myeloma patients. © 2000 Cancer Research Campaign

Evaluation of T cells as carriers for systemic measles virotherapy in the presence of antiviral antibodies

“…Indeed, efficacy of vaccination of myeloma patients against influenza, Streptococcus pneumoniae and Haemophilus influenza type B is poor, and only a small percentage of patients achieved protective antibodies owing to their impaired immune status. 31 Indeed, we previously determined that the average anti-MV Ab titers in myeloma patients (36.58735.99 EU/ml, n ¼ 10) were lower than in healthy individuals (100759.17 EU/ml, n ¼ 10). 11 This is an appealing feature that should favor measles virotherapy in this cohort of patients, especially as the current study demonstrates that cell-free virus can be delivered to and successfully spread in tumors at low titers of Ab.…”

Limiting early mortality: Do's and don'ts in the management of patients with newly diagnosed multiple myeloma

“…Various studies evaluating the efficacy of vaccinations in MM have demonstrated poor antibody responses [67]. Nevertheless, vaccinations against the influenza virus, S. pneumonaie and H. influenza are recommended if possible but their efficacy is not guaranteed.…”

Pneumococcal native aortic valve endocarditis with mycotic abdominal aortic aneurysm, paraspinal and iliopsoas abscesses and pneumonia revealing a multiple myeloma

“…However, patients with multiple myeloma were often unable to mount an adequate humoral response to vaccination. As many as 61 % of the patients failed to demonstrate a protective level of antibody titre even after vaccination against S. pneumoniae (Robertson et al, 2000). Thus, in recent years, the use of prophylactic intravenous immunoglobulin has been proposed.…”