IMW 2019: Getting Vaccinated Following Stem Cell Transplant with Maximillian Merz, MD, Roswell Park Cancer Institute
Are myeloma patients still considered "vaccinated" following a stem cell transplant? Dr. Maximillian Merz joins the Myeloma Crowd at the recent IMW meeting in Boston to share recent findings.
It is believed that patients should get vaccinated after transplant, but this is the first time that it has been tested to see if patients responded to the vaccines post-transplant and remain protected. In the study, the researchers studied titers (A titer test is a laboratory blood test that checks to see if someone is immune to a certain virus or needs to be vaccinated) after transplant and then again after lenalidomide maintenance therapy.
The researchers found vaccination after transplant is successful. About 20% of patients following transplant still have immunity to common diseases. Sixty percent of patients who received vaccination after transplant showed positive titers after they were vaccinated. It was noted that some patients did not, so it is important to check for titers after patients get vaccinated to see if it was effective.
Patients who had negative titers and became titer positive had better progression free and overall survival. A large percentage (70%) of Stage III myeloma patients who converted from negative to positive titers had a 100% overall survival after 3 years on the study.
Still, 20% of patients do not respond to vaccinations after transplant, so patients should be tested after transplant and after vaccination to see if the vaccinations have taken effect.
When should patients get vaccinated after stem cell transplant? Dr. Merz recommends between 6-12 months after transplant for inactivated vaccines only. He suggests waiting on live vaccines such as measles for 2 years because there might be side effects if it is given too close to transplant. Patients should also protect themselves by getting the seasonal flu shot as well.