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Prevention of infections including vaccination strategies in multiple myeloma
1Department of Medicine I, Center for Medical Oncology and Hematology with Outpatient Department and Palliative Care, Wilhelminen Cancer Research Institute, Vienna, Austria.
Abstract:
Infections are a major cause of morbidity and mortality in multiple myeloma. The increased risk for bacterial and viral infections results mainly from the disease-inherent and treatment-induced immunosuppression. Additional risk factors are older age with immune senescence, T cell depletion, polymorbidity, and male gender. Hence, every effort should be taken to reduce the risk for infections by identifying patients at higher risk for these complications and by implementing prophylactic measures, including chemoprophylaxis and immunization against various relevant pathogens. Here, we review the available evidence and provide recommendations for medical prophylaxis and vaccination in clinical practice.
Insights
Multiple myeloma patients face high infection risks due to immunosuppression. Prophylactic measures, including chemoprophylaxis and vaccinations, are crucial for reducing morbidity and mortality in these individuals.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Infections significantly contribute to morbidity and mortality in multiple myeloma patients.
- Disease-inherent and treatment-induced immunosuppression are primary drivers of infection risk.
- Older age, immune senescence, T cell depletion, polymorbidity, and male gender exacerbate infection susceptibility.
Purpose of the Study:
- To review evidence on infection risk in multiple myeloma.
- To provide recommendations for medical prophylaxis and vaccination strategies.
- To identify high-risk patients for targeted interventions.
Main Methods:
- Literature review of available evidence on infections in multiple myeloma.
- Analysis of risk factors contributing to immunosuppression.
- Synthesis of data to formulate clinical practice recommendations.
Main Results:
- Multiple myeloma patients exhibit a substantially increased risk of bacterial and viral infections.
- Immunosuppression, stemming from both the disease and its treatments, is the principal cause.
- Age, immune senescence, T cell depletion, comorbidities, and male sex are identified as additional risk factors.
Conclusions:
- Prophylactic strategies, including chemoprophylaxis and vaccinations, are essential for managing infection risk.
- Early identification of high-risk patients is critical for implementing effective preventative measures.
- Comprehensive prophylaxis and vaccination protocols can mitigate infection-related complications in multiple myeloma care.
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