Vaccinating Against Pneumonia in Patients With Myeloma
Posted: Friday, July 31, 2020
The 13-valent pneumococcal conjugate vaccine (PCV13) was shown to be effective when three doses were given with a minimum 1-month interval between courses of novel therapies in patients with multiple myeloma. Anatoly Uss, MD, DSc, of the Minsk Scientific and Practical Center of Surgery in Belarus, and colleagues published their work in the journal Vaccine.
“Despite the expected decrease in immunological response to vaccination during the chemotherapy, we have shown the clinical effectiveness of [the] PCV13 vaccination schedule,” concluded the authors.
The research team recruited 36 adults with multiple myeloma from 2017 through 2019. These patients were all treated with novel agents such as bortezomib, lenalidomide, or ixazomib. Participants were randomly given either three doses of PSV13 with a minimum 1-month interval from vaccination to continuation of novel agent therapy or no vaccination. Patients who did not receive the vaccine were on standard infection prevention measures.
Among the 36 patients in the study, there were 12 confirmed cases of pneumonia: 3 in the vaccinated group and 9 in the nonvaccinated group. This equated to an absolute risk reduction of 33.3% when patients were vaccinated with PCV13 and a number needed to treat of 3.0. Only one patient in the nonvaccinated group had cultures that grew out Streptococcus pneumoniae, despite three patients showing gram-negative diplococci on microscopy. All patients who developed pneumonia were treated with cefepime, ceftazidime, or linezolid based on physician choice.
Multivariate analysis showed that sex, creatinine level greater than 2 mg/dL, a hemoglobin level below 10 mg/dL, and PCV13 vaccination were associated with the likelihood of developing pneumonia. However, PCV13 vaccination alone was found to yield an independent and statistically significant effect. There were no adverse events noted as a result of either development of pneumonia or vaccination in any patient.
Disclosure: The authors reported no conflicts of interest.