Rates of influenza and pneumococcal vaccination and correlation with survival in multiple myeloma patients


Michael A. Thompson, Advocate Aurora HealthFollow
Mario Boccadoro, Division of Hematology, University of Torino, Torino, Italy.Follow
Xavier Leleu, Pôle Régional de Cancérologie, Department of Hematology, CHU La Milétrie-Poitiers, Poitiers, France.
Jorge Vela-Ojeda, Department of Hematology, UMAE Hospital de Especialidades Centro Medico La Raza IMSS, Mexico City, Mexico.
Frits van Rhee, University of Arkansas for Medical Sciences, Little Rock, AR.
Katja C. Weisel, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Robert M. Rifkin, Rocky Mountain Cancer Centers/US Oncology Research, Denver, CO.
Saad Z. Usmani, Levine Cancer Institute, Charlotte, NC.
Roman Hájek, Department of Hemato-oncology, University Hospital Ostrava, and Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
Gordon Cook, Leeds Cancer Centre, Leeds Teaching Hospitals Trust, Leeds, UK.Follow
Rafat Abonour, Indiana University School of Medicine, Indianapolis, IN.Follow
Mira Armour, Mijelom CRO, Croatian Myeloma Support Association, Zagreb, Croatia.
Kathryn E. Morgan, Myeloma Patients Europe, Brussels, Belgium.
Su-Peng Yeh, China Medical University Hospital, Taichung City, P.R.China.
Caitlin L. Costello, University of California San Diego, La Jolla, CA.Follow
Jesus G. Berdeja, Department of Hematology, Tennessee Oncology and Sarah Cannon Research Institute, Nashville, TN.Follow
Faith E. Davies, Perlmutter Cancer Center, NYU Langone, New York, NY.Follow
Jeffrey A. Zonder, Department of Malignant Hematology, Barbara Ann Karmanos Cancer Institute/Wayne State University School of Medicine, Detroit, MI.
Hans C. Lee, Department of Lymphoma and Myeloma, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
Jim Omel, The Central Nebraska Myeloma Support Group, Grand Island, NE.
Andrew Spencer, Malignant Haematology and Stem Cell Transplantation Service, Alfred Health Monash University, Melbourne, Australia.
Evangelos Terpos, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
Vania T. Hungria, Department of Hematology, Clinica São Germano and Santa Casa Medical School, São Paulo, Brazil.
Noemi Puig, Hematology Department, Hospital Universitario de Salamanca (HUSAL), IBSAL, IBMCC (USAL-CSIC), CIBERONC, Salamanca, Spain.
Chengcheng Fu, First Affiliated Hospital, Soochow University, Suzhou Jiangsu, P.R.China.
Renda H. Ferrari, Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA.
Kaili Ren, Takeda Development Center Americas, Inc. (TDCA), Lexington, MA.
Dawn Marie Stull, Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA.
Ajai Chari, Department of Hematology-Oncology, Mount Sinai School of Medicine, New York, NY.Follow


Aurora Cancer Care, Advocate Aurora Research Institute


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.

Document Type


PubMed ID