Rates of Influenza and Pneumococcal Vaccination and Correlation With Survival in Multiple Myeloma Patients

Michael A. Thompson, Mario Boccadoro, Xavier Leleu, Jorge Vela-Ojeda, Frits van Rhee, Katja C. Weisel, Robert M. Rifkin, Saad Z. Usmani, Roman Hájek, Gordon Cook, Rafat Abonour, Mira Armour, Kathryn E. Morgan, Su Peng Yeh, Caitlin L. Costello, Jesus G. Berdeja, Faith E. Davies, Jeffrey A. Zonder, Hans C. Lee, Jim OmelAndrew Spencer, Evangelos Terpos, Vania T.M. Hungria, Noemi Puig, Chengcheng Fu, Renda H. Ferrari, Kaili Ren, Dawn Marie Stull, Ajai Chari

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)e171-e181
JournalClinical Lymphoma, Myeloma and Leukemia
Issue number3
StatePublished - Mar 2023


  • Infection
  • Multiple myeloma
  • Supportive care
  • Survival
  • Vaccination


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