Antibody response to infection in multiple myeloma. Implications for vaccination

We report the humoral immune response of a patient with multiple myeloma to rapidly successive episodes of meningococcal and pneumococcal meningitis. Specific antibody responses included a high bactericidal titer (1:640) against the infecting meningococcus and a sharp increase (from 198 to 8,097 ng/ml antibody nitrogen) in antibody to the type-specific capsular polysaccharide of the infecting pneumococcus. These data, showing the production of protective antibodies against the two pathogens, suggest that some patients with multiple myeloma might also respond to appropriately administered bacterial vaccines. This fact should be ascertained because vaccination could potentially reduce the high rate of bacterial infections associated with this disease.