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Rates of Influenza and Pneumococcal Vaccination and Correlation With Survival in Multiple Myeloma Patients
Michael A Thompson1, Mario Boccadoro2, Xavier Leleu3
1Aurora Cancer Care, Advocate Aurora Research Institute, Advocate Aurora Health, Milwaukee, WI,.
Background:
Infections are a common reason for hospitalization and death in multiple myeloma (MM). Although pneumococcal vaccination (PV) and influenza vaccination (FV) are recommended for MM patients, data on vaccination status and outcomes are limited in MM.
Materials And Methods:
We utilized data from the global, prospective, observational INSIGHT MM study to analyze FV and PV rates and associated outcomes of patients with MM enrolled 2016-2019.
Results:
Of the 4307 patients enrolled, 2543 and 2500 had study-entry data on FV and PV status. Overall vaccination rates were low (FV 39.6%, PV 30.2%) and varied by region. On separate multivariable analyses of overall survival (OS) by Cox model, FV in the prior 2 years and PV in the prior 5 years impacted OS (vs. no vaccination; FV: HR, 0.73; 95% CI, 0.60-0.90; P = .003; PV: HR, 0.51; 95% CI, 0.42-0.63; P < .0001) when adjusted for age, region, performance status, disease stage, cytogenetics at diagnosis, MM symptoms, disease status, time since diagnosis, and prior transplant. Proportions of deaths due to infections were lower among vaccinated versus non-vaccinated patients (FV: 9.8% vs. 15.3%, P = .142; PV: 9.9% vs. 18.0%, P = .032). Patients with FV had generally lower health resource utilization (HRU) versus patients without FV; patients with PV had higher or similar HRU versus patients without PV.
Conclusion:
Vaccination is important in MM and should be encouraged. Vaccination status should be recorded in prospective clinical trials as it may affect survival. This trial was registered at www.
Clinicaltrials:
gov as #NCT02761187.
Insights
Influenza and pneumococcal vaccinations are recommended for multiple myeloma patients. Vaccination is associated with improved overall survival and reduced infection-related deaths in multiple myeloma patients.
Area of Science:
- Hematology
- Infectious Diseases
- Oncology
Background:
- Infections are a significant cause of mortality and hospitalization in multiple myeloma (MM).
- While pneumococcal vaccination (PV) and influenza vaccination (FV) are recommended for MM patients, data on their impact on outcomes is limited.
- Low vaccination rates are observed globally in MM patients.
Purpose of the Study:
- To analyze influenza vaccination (FV) and pneumococcal vaccination (PV) rates in multiple myeloma (MM) patients.
- To evaluate the association between FV and PV status and patient outcomes, including overall survival (OS) and infection-related mortality.
- To assess health resource utilization (HRU) in vaccinated versus unvaccinated MM patients.
Main Methods:
- Utilized data from the global, prospective, observational INSIGHT MM study (2016-2019).
- Analyzed FV and PV status for 4307 enrolled patients.
- Employed multivariable Cox regression models to assess the impact of vaccination on OS, adjusting for various clinical factors.
Main Results:
- Overall vaccination rates were low: FV 39.6%, PV 30.2%, with regional variations.
- Both FV (HR, 0.73; P=.003) and PV (HR, 0.51; P<.0001) were associated with improved OS.
- Vaccinated patients had lower proportions of infection-related deaths (PV: 9.9% vs. 18.0%, P=.032).
- FV was linked to lower HRU, while PV showed higher or similar HRU compared to unvaccinated patients.
Conclusions:
- Vaccination is crucial for multiple myeloma patients and should be promoted.
- Vaccination status is an important factor influencing survival outcomes in MM and should be recorded in clinical trials.
- Encouraging FV and PV can potentially improve survival and reduce infection-related mortality in MM patients.
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