Page 189 - Haematologica Vol. 110 - January 2025

LETTER TO THE EDITOR
AB
Figure 1. Cumulative incidence of infections in multiple myeloma patients and controls. (A) Cumulative incidence of Respiratory Syncytial virus infection in multiple myeloma patients and controls. (B) Cumulative incidence of pneumococcal infection in mul- tiple myeloma patients and controls.
status among the other 70% is unknown.
Another limitation is the possibility that some of the infec- tions might be underreported. This might be even more pro- nounced among MM patients compared to healthy controls. Further, we are lacking severity data. Most of the diagno- ses on infectious disease are retrieved from the inpatient registry. But we do not know whether MM patients in the study were hospitalized for longer periods of time than controls or needed more ventilatory support. There is however extensive data in the literature showing that MM patients have a greater infectious morbidity and mortality compared to the healthy population.14,15
We conclude that most vaccine-preventable infections, including RSV and pneumococcal infection, are heavily over- represented in MM patients compared to healthy controls. Their incidence was found to increase over time. Some of the RSV infections can potentially be prevented or more importantly, their severity mitigated, by the newly intro- duced RSV vaccines. From the data in our study, it seems important not to exclude older patients and patients in later lines of treatment from vaccination and vaccine efficacy studies. Vaccinations are in recent studies underused in MM, despite their proven efficacy. Our data suggest that they should be encouraged along with other measures, to prevent infections. Prospective vaccine trials in MM patients receiving modern therapy with bi-specific antibodies and CAR T cells are urgently needed.
Authors
Sigrun Einarsdottir,1,2 Ingigerdur Sverrisdottir,2,3 Mariana Villegas- Scivetti,1,2 Chris Day,2 Ingemar Turesson,4 Gunnar Juliusson,4 Markus
Hansson,1,2 Gunnar Larfors5 and Cecilie Hveding Blimark1,2
1Department of Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 2Department of Hematology and Coagulation, Sahlgrenska University Hospital, Gothenburg, Sweden; 3Department of Medicine, University of Iceland, Reykjavik, Iceland; 4Skåne University Hospital, Malmö/Lund, Sweden and 5Unit of Hematology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
Correspondence:
S. EINARSDOTTIR - sigrun.einarsdottir@vgregion.se
https://doi.org/10.3324/haematol.2024.285161
Received: January 26, 2024. Accepted: June 18, 2024. Early view: June 27, 2024.
©2025 Ferrata Storti Foundation Published under a CC BY-NC license
Disclosures
SE discloses honoraria from AstraZeneca. MV-S discloses honoraria from Roche, Janssen–Cilag and Leo Pharma 2024. GJ discloses honoraria from AbbVie, Jazz, Novartis and Servier; research cooperation with Laboratoire Delbert. GL discloses consultancy for Xspray. CHB discloses honoraria from BMS, Janssen, Sanofi and Amgen; advisory board participation at Takeda and Janssen.
Contributions
CB designed the trial, sought the ethical approval, wrote the project plan and participated in analyzing data and writing of the
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